摘要目的:探讨MR 3D STIR SPACE和True FISP成像技术对臂丛神经病变的诊断价值。方法:回顾性分析28例临床诊断臂丛神经疾病患者(包括臂丛神经损伤20例,胸廓出口综合征3例和臂丛神经肿瘤5例),检查使用Siemens 1.5T磁共振仪。所有病例采用3D STIR SPACE(带翻转恢复脉冲的可变翻转角快速自旋回波三维成像)和3D True FISP(真稳态进动快速三维成像)序列扫描。分析MR影像表现,并与手术结果比较。结果:臂丛神经节前损伤的直接征象包括神经根缺失或断裂,间接征象包括硬膜囊变形、创伤性脊膜囊肿。臂丛神经节后损伤征象包括臂丛神经增粗、迂曲、水肿,软组织水肿。臂丛神经损伤共23例(包含3例胸廓出口综合征),患侧臂丛神经根共115根。联合应用MR 3D STIR SPACE 和True FISP成像技术对臂丛神经损伤诊断的灵敏度为81.97%,特异度为87.01%,准确性为84.78%;臂丛神经肿瘤5例,MR诊断与手术部位、大小一致。结论:联合应用MR 3D STIR SPACE和True FISP成像技术,能同时满足臂丛神经节前及节后病变的诊断,对臂丛神经疾病具有较高的诊断价值。
Abstract:Objective: To investigate the value of MR 3D STIR SPACE and True FISP techniques in diagnosis of brachial plexus lesions. Methods: Twenty-eight cases of brachial plexus disease (including 20 cases of brachial plexus injury, 3 cases of thoracic outlet syndrome and 5 cases of brachial plexus tumors) were examined by 1.5T Siemens magnetic resonance. All cases were scanned by both 3D STIR SPACE and 3D TRUE FISP sequences. Comparative diagnosis of MR imaging and surgical results was performed. Results: The direct signs of brachial plexus preganglionic injury included absence or rupture of nerve root and indirect signs included deformation of dural sac, post-traumatic spinal meningocele. Signs of postganglionic brachial plexus injury included thickening, tortuosity or edema of brachial plexus and soft tissue edema. There were 23 cases with 115 brachial plexus roots in total. MR imaging in diagnosis of brachial plexus injury showed 81.97% in the sensitivity, 84.78% in the specificity, and 84.78% in the accuracy. Five cases of brachial plexus tumors confirmed by surgery were diagnosed correctly by MRI. Conclusion: Combination of 3D STIR SPACE and True FISP sequences can clearly display the postganglionic and preganglionic brachial plexus lesions and those protocols are valuable in diagnosis of branchial plexopathy.
娄路馨,于爱红,程晓光,白荣杰,张 晶,李 娜. 联合应用MR 3D STIR SPACE和True FISP成像序列对臂丛神经病变的诊断价值[J]. 中国临床医学影像杂志, 2016, 27(9): 654-658.
LOU Lu-xin, YU Ai-hong, CHENG Xiao-guang, BAI Rong-jie, ZHANG Jing, LI Na. Diagnosis of brachial plexopathy by MR 3D STIR SPACE and True FISP sequence. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(9): 654-658.
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