Qin Ben-Gang, Yang Jian-Tao, Yang Yi, Wang Hong-Gang, Fu Guo, Gu Li-Qiang, Li Ping, Zhu Qing-Tang, Liu Xiao-Lin, Zhu Jia-Kai
Department of Microsurgery, Orthopaedic Trauma &Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou guangdong, 510080, P.R. China.
Sci Rep. 2016 Oct 26;6:35999. doi: 10.1038/srep35999.
Three-dimensional diffusion-weighted steady-state free precession (3D DW-SSFP) of high-resolution magnetic resonance has emerged as a promising method to visualize the peripheral nerves. In this study, the application value of 3D DW-SSFP brachial plexus imaging in the diagnosis of brachial plexus injury (BPI) was investigated. 33 patients with BPI were prospectively examined using 3D DW-SSFP MR neurography (MRN) of brachial plexus. Results of 3D DW-SSFP MRN were compared with intraoperative findings and measurements of electromyogram (EMG) or somatosensory evoked potentials (SEP) for each injured nerve root. 3D DW-SSFP MRN of brachial plexus has enabled good visualization of the small components of the brachial plexus. The postganglionic section of the brachial plexus was clearly visible in 26 patients, while the preganglionic section of the brachial plexus was clearly visible in 22 patients. Pseudomeningoceles were commonly observed in 23 patients. Others finding of MRN of brachial plexus included spinal cord offset (in 16 patients) and spinal cord deformation (in 6 patients). As for the 3D DW-SSFP MRN diagnosis of preganglionic BPI, the sensitivity, the specificity and the accuracy were respectively 96.8%, 90.29%, and 94.18%. 3D DW-SSFP MRN of brachial plexus improve visualization of brachial plexus and benefit to determine the extent of injury.
高分辨率磁共振三维扩散加权稳态自由进动（3D DW-SSFP）已成为一种可视化周围神经的有前景的方法。在本研究中，探讨了3D DW-SSFP臂丛神经成像在臂丛神经损伤（BPI）诊断中的应用价值。对33例BPI患者进行了臂丛神经3D DW-SSFP磁共振神经成像（MRN）的前瞻性检查。将3D DW-SSFP MRN的结果与术中发现以及每条受损神经根的肌电图（EMG）或体感诱发电位（SEP）测量结果进行比较。臂丛神经的3D DW-SSFP MRN能够很好地显示臂丛神经的小分支。26例患者臂丛神经节后段清晰可见，22例患者臂丛神经节前段清晰可见。23例患者中常见假性脑脊膜膨出。臂丛神经MRN的其他发现包括脊髓偏移（16例患者）和脊髓变形（6例患者）。对于节前性BPI的3D DW-SSFP MRN诊断，敏感性、特异性和准确性分别为96.8%、90.29%和94.18%。臂丛神经的3D DW-SSFP MRN改善了臂丛神经的可视化，并有助于确定损伤程度。
