Qin Bengang, Gu Liqiang, Liu Xiaolin, Zhang Zhongwei, Xiang Jianping, Wang Honggang, Fu Guo
Orthopaedic Trauma & Microsurgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong 510080, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Dec;22(12):1455-7.
To evaluate the value of MRI in diagnosis of obstetrical brachial plexus palsy pre-ganglionic injury.
From November 2006 to February 2008, 10 patients with obstetrical brachial plexus palsy were treated, 8 males and 2 females, aged from 2 months to 3 years (11.4 months on average). There were 7 cases of left side and 3 of right side. According to Tassin classification, 2 cases were type II, 6 type III and 2 type IV. All patients were performed MRI examinations before the operation, whose results were compared with those of exploration during the operation.
MRI examinations showed 1 patient was normal and 9 patients had post-traumatic spinalmeningolcele. The 6 patients had displacement of spinal cord (4 towards the healthy side and 2 towards the sick side), 6 had deformity of spinal cord, and 2 had avulsed nerve root thickening. MRI detected 19 nerve roots were positive, 16 were true positive and 3 false positive in surgical exploration. MRI detected 6 nerve roots were negative, 4 were true negative and 2 false negative in surgical exploration. The sensitivity, specificity and accuracy of MRI in diagnosis of obstetrical brachial plexus palsy pre-ganglionic injury were 84.2%, 80.0% and 83.3%, respectively. There were significant differences in the results by preoperative MRI examinations and by exploration during the operation (P < 0.05).
MRI can show pre-ganglionic injury of brachial plexus of the patients with obstetrical brachial plexus palsy and can supply references for early diagnosis and operation time. MRI can be routinely conducted as a preoperative examination.
评估磁共振成像（MRI）在诊断产瘫节前损伤中的价值。
2006年11月至2008年2月，收治10例产瘫患者，男8例，女2例，年龄2个月至3岁（平均11.4个月）。左侧7例，右侧3例。根据塔辛分类，Ⅱ型2例，Ⅲ型6例，Ⅳ型2例。所有患者术前均行MRI检查，并将结果与术中探查结果进行比较。
MRI检查显示1例正常，9例有创伤后脊膜膨出。6例脊髓有移位（4例向健侧，2例向患侧），6例脊髓有畸形，2例神经根撕脱增粗。MRI检测出19条神经根阳性，手术探查中16条为真阳性，3条为假阳性。MRI检测出6条神经根阴性，手术探查中4条为真阴性，2条为假阴性。MRI诊断产瘫节前损伤的灵敏度、特异度和准确度分别为84.2%、80.0%和83.3%。术前MRI检查结果与术中探查结果差异有统计学意义（P<0.05）。
MRI可显示产瘫患者臂丛神经节前损伤情况，为早期诊断及手术时机选择提供参考，可作为术前常规检查。
