Sato H, Iwahashi T, Morita H, Yahikozawa H, Ikeda S
Department of Medicine (Neurology), Shinshu University School of Medicine, Matsumoto, Japan.
Rinsho Shinkeigaku. 1999 Apr;39(4):471-4.
We reported valuable MRI findings of the brachial plexus seen in two cases with chronic inflammatory demyelinating polyneuropathy (CIDP). Case 1 was a 44-year-old man who developed slowly progressive weakness and atrophy of the extremities with no sensory disturbances. Studies of CSF showed a normal level of protein and no increase of cell counts but nerve conduction studies demonstrated a significant conduction block between the axilla and the elbow in the right ulnar nerve. Case 2 was a 34-year-old male who had been suffering from distal limb weakness and sensory disturbance. Protein content in CSF was markedly elevated without pleocytosis, and nerve conduction studies revealed a conduction block between the elbow and the wrist in the right ulnar nerve. He received corticosteroid therapy, resulting in a good recovery. Brachial plexus in both cases showed enlargement with marked high signal on short TI inversion recovery (STIR) of MRI. STIR is a fat suppressed T2 weighted image and this technique is known to be useful to identify the morphology of peripheral nerve tissues. CIDP is one form of hypertrophic neuritis and the MRI findings seen in these two cases strongly support the diagnosis of CIDP.
我们报告了在两例慢性炎症性脱髓鞘性多发性神经病(CIDP)患者中观察到的臂丛神经的有价值的MRI表现。病例1是一名44岁男性,出现四肢缓慢进行性无力和萎缩,无感觉障碍。脑脊液检查显示蛋白水平正常,细胞计数无增加,但神经传导研究显示右侧尺神经在腋窝和肘部之间存在明显的传导阻滞。病例2是一名34岁男性,患有远端肢体无力和感觉障碍。脑脊液中的蛋白含量明显升高,无细胞增多,神经传导研究显示右侧尺神经在肘部和腕部之间存在传导阻滞。他接受了皮质类固醇治疗,恢复良好。两例患者的臂丛神经在MRI的短TI反转恢复序列(STIR)上均显示增粗并伴有明显高信号。STIR是一种脂肪抑制T2加权图像,已知该技术有助于识别周围神经组织的形态。CIDP是肥大性神经炎的一种形式,这两例患者的MRI表现有力地支持了CIDP的诊断。