Abstract:
3D SHINKEI neurography is a new sequence for imaging the peripheral nerves. The study aims at assessing traumatic brachial plexus injury using this sequence. Fifty-eight patients with suspected trauma induced brachial plexus injury underwent MR neurography (MRN) imaging in 3D SHINKEI sequence at 3 T. Surgery and intraoperative somatosensory evoked potentials or clinical follow-up results were used as the reference standard. MRN, surgery and electromyography (EMG) findings were recorded at four levels of the brachial plexus-roots, trunks, cords and branches. Fifty-eight patients had pre- or postganglionic injury. The C5-C6 nerve postganglionic segment was the most common (average 42%) among the postganglionic injuries detected by 3D SHINKEI MRN. The diagnostic accuracy (83.75%) and the specificity (90.30%) of MRN higher than that of EMG (p < 0.001). There was no significant difference in the diagnostic sensitivity of MRN compared with EMG (p > 0.05). Eighteen patients with brachial plexus injury underwent surgical exploration after MRN examination and the correlation between MRN and surgery was 66.7%. Due to the high diagnostic accuracy and specificity, 3D SHINKEI MRN can comprehensively display the traumatic brachial plexus injury. This sequence has great potential in the accurate diagnosis of traumatic brachial plexus injury.
摘要:
3DSHINKEI神经成像是一种用于周围神经成像的新序列。该研究旨在使用该序列评估创伤性臂丛神经损伤。58例疑似外伤导致臂丛神经损伤的患者在3T时接受了3DSHINKEI序列的MR神经成像(MRN)成像。手术和术中体感诱发电位或临床随访结果作为参考标准。MRN,手术和肌电图(EMG)的发现记录在臂丛神经根的四个水平,树干,绳索和树枝。58例患者有节前或节后损伤。在3DSHINKEIMRN检测到的节后损伤中,C5-C6神经节后段是最常见的(平均42%)。MRN的诊断准确性(83.75%)和特异性(90.30%)高于EMG(p<0.001)。MRN诊断敏感性与EMG比较差异无统计学意义(p>0.05)。18例臂丛神经损伤患者经MRN检查后行手术探查,MRN与手术的相关性为66.7%。由于诊断的准确性和特异性高,3DSHINKEIMRN能全面显示创伤性臂丛神经损伤。该序列在创伤性臂丛神经损伤的准确诊断中具有很大的潜力。