Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Acad Radiol. 2011 Aug;18(8):1049-59. doi: 10.1016/j.acra.2011.03.003. Epub 2011 May 4.
The purpose of this study was to illustrate the imaging findings on high-resolution 3T magnetic resonance neurography (MRN) in patients with suprascapular nerve (SSN) neuropathy.
From 3T MRN examinations performed for brachial plexus evaluation in 51 patients over a 3-year period, 15 patients with final diagnosis of suprascapular neuropathy were recruited. The diagnosis was confirmed by electrodiagnostic studies (EDS), clinical, and/or surgical follow-up examinations. Studies performed for the evaluation of tumor, neurofibromatosis, or known diffuse polyneuropathy were excluded.
Two cases were excluded due to suboptimal imaging related to motion degradation and poor signal-to-noise ratio. MRN depicted asymmetric enlargement and/or abnormal T2 hyperintensity of C5 nerve root (10/13 cases), C6 nerve root (10/13 cases), both C5 and C6 nerve roots (7/13 cases), upper trunk (11/13 cases) and SSN (11/13 cases), and other brachial plexus segments involvement (4/13 cases). MR findings of denervation changes in the ipsilateral supraspinatus and infraspinatus muscles were detected in 12/13 cases. In all seven cases where contrast-enhanced images were available, MRN demonstrated enhancement of the denervated muscles but did not provide any additional information regarding the nerve abnormality. None of the MRN studies revealed a mass lesion along the course of the SSN.
3T MRN is a valuable diagnostic tool in clinically suspected cases of suprascapular neuropathy, because it can directly demonstrate the nerve abnormality, as well as secondary muscle denervation changes. The reader should be aware that brachial plexopathy may coexist in patients with clinical diagnosis of SSN neuropathy.
本研究旨在展示高分辨率 3T 磁共振神经成像（MRN）在肩胛上神经（SSN）神经病患者中的影像学表现。
在过去 3 年的时间里，对 51 例进行臂丛评估的 3T MRN 检查中，有 15 例患者最终诊断为肩胛上神经病。通过电诊断研究（EDS）、临床和/或手术随访检查来确诊。排除了用于评估肿瘤、神经纤维瘤病或已知弥漫性多发性神经病的研究。
由于运动退化和信噪比差导致的图像质量不佳，有 2 例病例被排除在外。MRN 显示 C5 神经根（10/13 例）、C6 神经根（10/13 例）、C5 和 C6 神经根（7/13 例）、上干（11/13 例）和 SSN（11/13 例）不对称增大和/或异常 T2 高信号，以及其他臂丛节段受累（13 例中的 4 例）。在 13 例中，同侧冈上肌和冈下肌的失神经改变的 MR 发现。在所有 7 例可获得对比增强图像的情况下，MRN 显示失神经肌肉增强，但没有提供关于神经异常的任何其他信息。在 SSN 走行过程中，MRN 研究均未显示肿块病变。
3T MRN 是临床上疑似肩胛上神经病的有价值的诊断工具，因为它可以直接显示神经异常以及继发性肌肉失神经改变。读者应该注意，在临床诊断为 SSN 神经病的患者中，可能同时存在臂丛神经病。
