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磁共振成像在卡压性神经病中的作用——如何在肌肉骨骼磁共振图像上观察周围神经:部位、位置及方法:第2部分。上肢

Role of magnetic resonance imaging in entrapment and compressive neuropathy--what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity.

作者信息

Kim Sungjun, Choi Jin-Young, Huh Yong-Min, Song Ho-Taek, Lee Sung-Ah, Kim Seung Min, Suh Jin-Suck

机构信息

Department of Diagnostic Radiology, College of Medicine, Yonsei University, 134, Shinchondong, Seodaemun-ku, 120-752 Seoul, South Korea.

出版信息

Eur Radiol. 2007 Feb;17(2):509-22. doi: 10.1007/s00330-006-0180-y. Epub 2006 Mar 30.

Abstract

The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging.

摘要

神经卡压和压迫性神经病变的诊断传统上基于临床和电诊断检查。由于磁共振(MR)成像技术的改进,它不仅在占位性病变的检测中发挥着重要作用,而且在临床和电诊断结果不明确的病例中也起到补充作用。尽管超声在过去几十年中得到了进一步发展并显示出高分辨率能力,但由于其对操作者的依赖性,它存在固有的局限性。我们根据受累神经,回顾上肢正常周围神经的走行,以及MR成像中受压和卡压神经的各种临床表现和病理特征。上肢神经卡压的常见部位如下:胸廓出口的臂丛神经;四边孔的腋神经;桡管的桡神经;肘管和Guyon管的尺神经;旋前圆肌综合征、骨间前神经综合征和腕管综合征的正中神经。尽管MR成像可以有效地描绘四肢的周围神经,但放射科医生应熟悉神经走行、神经受压的常见部位以及MR成像中导致神经受压的常见占位性病变。

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