Roger B, Travers V, Sedel L, Cabanis E A, Laval-Jeantet M
Service de Radiologie, Hôpital Saint-Louis, Paris.
J Radiol. 1989 Mar;70(3):197-208.
We have used magnetic resonance imaging in addition to the other imaging techniques for the examination of 31 patients with traumatic upper limb paralysis. The therapeutic indications of traumatic brachial plexus paralysis depend on the early and precise assessment of the lesions. Computed tomography with a contrast injection at a lumbar level opacifying the subarachnoid spaces provides a morphological study of the canal, spine and nerve roots and of container-contents relationships. In our experience, the diagnostic reliability for the detection of intraspinal radicular lesions is 86%. A study in all 3 spatial planes is possible with MRI with T1- and T2-weighted or gradient echo sequences. The reliability of the technique for the diagnosis of meningoceles in the detection of nerve root avulsion is similar to that of CT (85%). The excellent spatial resolution and natural high contrast allow following the nerve roots in their extraspinal course and determining the site of nerve trunk rupture (50%). The use of oblique and double-obliquity sections should yet improve these results. These first results lead us to proposing magnetic resonance imaging for the exploration of traumatic lesions of the brachial plexus. This nonagressive, more precise and more complete assessment of the lesions certainly has a significant influence on therapeutic choice.
除了其他成像技术外，我们还使用磁共振成像对31例创伤性上肢麻痹患者进行了检查。创伤性臂丛神经麻痹的治疗指征取决于对病变的早期精确评估。在腰椎水平注入造影剂使蛛网膜下腔显影的计算机断层扫描可对椎管、脊柱、神经根以及容纳物与内容物的关系进行形态学研究。根据我们的经验，检测脊髓内神经根病变的诊断可靠性为86%。利用T1加权、T2加权或梯度回波序列的磁共振成像可以在所有三个空间平面上进行研究。该技术在检测神经根撕脱时诊断脊膜膨出的可靠性与CT相似（85%）。出色的空间分辨率和天然的高对比度能够追踪椎管外走行的神经根并确定神经干断裂的部位（50%）。使用斜位和双斜位切面应该会改善这些结果。这些初步结果使我们建议使用磁共振成像来探查臂丛神经的创伤性病变。这种对病变进行的无创、更精确且更全面的评估无疑会对治疗选择产生重大影响。
