Andreisek Gustav, Crook David W, Burg Doris, Marincek Borut, Weishaupt Dominik
Institute for Diagnostic Radiology, Department of Medical Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
Radiographics. 2006 Sep-Oct;26(5):1267-87. doi: 10.1148/rg.265055712.
The median, radial, and ulnar nerves of the upper limbs may be affected by various peripheral neuropathies, each of which may be categorized according to its cause, as either an entrapment or a nonentrapment neuropathy. Entrapment neuropathies, also referred to as nerve compression syndromes, include the supracondylar process syndrome, pronator syndrome, anterior interosseous nerve syndrome, carpal tunnel syndrome, posterior interosseous nerve syndrome, cubital tunnel syndrome, and Guyon canal syndrome. Nonentrapment neuropathies include traumatic nerve injuries, infectious and inflammatory conditions, polyneuropathies, and mass lesions at anatomic locations where entrapment syndromes typically do not occur. Although clinical examination and electrophysiologic testing are the cornerstone of the diagnostic work-up, in certain cases magnetic resonance (MR) imaging may provide key information about the exact anatomic location of a lesion or may help narrow the differential diagnosis. In patients with a diagnosis of peripheral neuropathy, MR imaging may help establish the cause of the condition and provide information crucial for conservative management or surgical planning. In addition, knowledge of the normal anatomy and of the possible causes, typical clinical findings, and MR imaging features of peripheral neuropathies that affect the median, radial, and ulnar nerves allows greater confidence in the diagnosis.
上肢的正中神经、桡神经和尺神经可能会受到各种周围神经病变的影响,每种病变可根据其病因分为卡压性或非卡压性神经病变。卡压性神经病变,也称为神经压迫综合征,包括髁上突综合征、旋前圆肌综合征、骨间前神经综合征、腕管综合征、骨间后神经综合征、肘管综合征和Guyon管综合征。非卡压性神经病变包括创伤性神经损伤、感染性和炎症性疾病、多发性神经病以及通常不发生卡压综合征的解剖部位的占位性病变。虽然临床检查和电生理测试是诊断检查的基石,但在某些情况下,磁共振(MR)成像可能会提供有关病变确切解剖位置的关键信息,或有助于缩小鉴别诊断范围。对于诊断为周围神经病变的患者,MR成像可能有助于确定病情原因,并提供对保守治疗或手术规划至关重要的信息。此外,了解影响正中神经、桡神经和尺神经的周围神经病变的正常解剖结构、可能病因、典型临床表现和MR成像特征,有助于提高诊断的信心。