Zhu Yong-Sheng, Mu Nan-Nan, Zheng Min-Juan, Zhang Yun-Chu, Feng Hua, Cong Rui, Zhou Xiao-Dong, Chen Ding-Zhang
Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'An, China.
Department of Ultrasonography, General Hospital of Jinan Military Area Command of Chinese PLA, Ji'Nan, China.
Ultrasound Med Biol. 2014 Jul;40(7):1420-6. doi: 10.1016/j.ultrasmedbio.2014.02.012. Epub 2014 Apr 24.
The aim of this study was to investigate the feasibility of using high-resolution ultrasonography in the diagnosis of brachial plexus (BP) root lesions. A prospective study of ultrasonographic evaluation of BP nerve roots was performed in 37 patients with BP root lesions (29 with root injuries, 8 with tumors). The pre-operative ultrasonographic findings were compared with the surgical and pathohistological findings. All C5-7 roots were detected by ultrasonography in all patients, whereas 92% (68/74) of C8 and 51% (38/74) of T1 nerve roots were visualized. Among 29 patients with BP root avulsion, partial injuries or totally interrupted BP roots were detected in all patients. Cystic masses and neuromas were detected in 16 and 23 patients, respectively. In 8 patients with BP root tumors, 8 hypo-echoic masses were detected inside or partly outside of intervertebral foramina connecting to nerve roots. Surgical exploration revealed that there were 57 BP root avulsions in 29 patients. However, 2 T1 nerve root avulsions had been missed by pre-operative ultrasonography. Pathohistology revealed that all 8 BP root tumors pre-operatively diagnosed by ultrasonography were schwannomas. High-resolution ultrasonography can provide a convenient and accurate imaging modality for quick diagnosis and location of BP root lesions.
本研究的目的是探讨使用高分辨率超声诊断臂丛神经（BP）根部病变的可行性。对37例BP根部病变患者（29例为根部损伤，8例为肿瘤）进行了BP神经根超声评估的前瞻性研究。将术前超声检查结果与手术及病理组织学结果进行比较。所有患者的C5 - 7神经根均能通过超声检测到，而C8神经根的可视化率为92%（68/74），T1神经根的可视化率为51%（38/74）。在29例BP根部撕脱患者中，所有患者均检测到部分损伤或完全中断的BP神经根。分别在16例和23例患者中检测到囊性肿块和神经瘤。在8例BP根部肿瘤患者中，在连接神经根的椎间孔内或部分椎间孔外检测到8个低回声肿块。手术探查发现29例患者中有57处BP根部撕脱。然而，术前超声检查漏诊了2处T1神经根撕脱。病理组织学显示，术前超声诊断的所有8例BP根部肿瘤均为神经鞘瘤。高分辨率超声可为BP根部病变的快速诊断和定位提供一种方便、准确的成像方式。
