Bashir Waseem A, Connell David A
Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, London, United Kingdom.
Semin Musculoskelet Radiol. 2008 Jun;12(2):170-81. doi: 10.1055/s-2008-1078704.
Although the subject of entrapment and compressive neuropathies is huge, with dedicated textbooks on the subject, this article attempts to provide an up-to-date overview of the role of imaging in the diagnosis of nerve entrapment and compression syndromes. Entrapment and compressive neuropathies are a group of distinct syndromes secondary to physical constriction or irritation affecting peripheral nerves at specific anatomical sites in the body. Most nerve entrapment and compressive syndromes derive from an injury to the neurovascular components in a narrow anatomical passage. Because of their etiological diversity, which includes pressure, angulation, stretch, and friction, the pathophysiology of individual nerve entrapment syndromes differs widely. Neuropathy can result in considerable morbidity. Although the mainstay of achieving diagnosis is with clinical acumen and electrophysiological investigations, the increasing use of modern high-resolution imaging studies is of particular value in confirming physical findings and enabling determination of the extent of injury. Knowledge and familiarity of pertinent anatomy and appropriate choice of imaging modality is important for the radiologist to allow accurate interpretation of site and etiology of nerve entrapment and compression as well as ascertaining possible alternative diagnoses.
尽管关于神经卡压和压迫性神经病的主题非常庞大,有专门论述该主题的教科书,但本文试图对影像学在神经卡压和压迫综合征诊断中的作用提供最新概述。神经卡压和压迫性神经病是一组独特的综合征,继发于身体特定解剖部位影响周围神经的物理性压迫或刺激。大多数神经卡压和压迫综合征源于狭窄解剖通道内神经血管成分的损伤。由于其病因的多样性,包括压力、成角、拉伸和摩擦,各个神经卡压综合征的病理生理学差异很大。神经病可导致相当大的发病率。虽然实现诊断的主要依据是临床敏锐度和电生理检查,但现代高分辨率影像学研究的日益广泛应用在确认体格检查结果以及确定损伤程度方面具有特别价值。对于放射科医生而言,了解和熟悉相关解剖结构并恰当选择成像方式,对于准确解释神经卡压和压迫的部位及病因以及确定可能的其他诊断很重要。