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磁共振神经成像在臂丛神经病诊断中的准确性。

Accuracy of MR neurography in the diagnosis of brachial plexopathy.

机构信息

Department of Radiology, University of Missouri School of Medicine One Hospital Drive, DC069.10, M292 Columbia, MO 65212, United States.

出版信息

Eur J Radiol. 2017 Oct;95:24-27. doi: 10.1016/j.ejrad.2017.07.012. Epub 2017 Jul 19.

Abstract

OBJECTIVE

To assess the accuracy of MR neurography (MRN) for the diagnosis for brachial plexopathy.

MATERIALS AND METHODS

Forty-three 43 consecutive cases or MRN with electrodiagnostic study correlation were reviewed independently by 2 readers. Established diagnostic criteria were employed: increased signal intensity, enlargement, loss of fascicular pattern, perineural edema and enhancement after administration of gadolinium contrast. An additional 37 cases without electrodiagnostic correlation were included in a second portion of the study, which evaluated interobserver variability.

RESULTS

The sensitivity of MRN ranged from 41.2% to 70.6%. Specificity was 97.7% to 100%. There was good interobserver agreement, with kappa value of 0.658. Odds ratio for agreement between observers at 3T vs. 1.5T was 1.30.

CONCLUSIONS

MRN of the brachial plexus showed only moderate sensitivity to brachial neuritis. Interobserver agreement was slightly higher at 3T than at 1.5T. MRN can be helpful in confirming an abnormal brachial plexus, but a normal MRN appearance of the plexus should not negate a clinical diagnosis.

摘要

目的

评估磁共振神经成像(MRN)对臂丛神经病的诊断准确性。

材料与方法

回顾性分析了 43 例连续病例或与电诊断研究相关的 MRN,由 2 位读者独立进行分析。采用了既定的诊断标准:钆对比剂给药后信号强度增加、扩大、束状模式丧失、神经周围水肿和增强。在研究的第二部分,还纳入了 37 例无电诊断相关性的病例,以评估观察者间的变异性。

结果

MRN 的灵敏度范围为 41.2%至 70.6%。特异性为 97.7%至 100%。观察者间具有良好的一致性,kappa 值为 0.658。在 3T 与 1.5T 之间,观察者间一致性的优势比为 1.30。

结论

臂丛磁共振神经成像对臂丛神经炎仅有中等的敏感性。在 3T 时观察者间的一致性略高于 1.5T。MRN 有助于证实异常的臂丛,但正常的臂丛丛磁共振成像表现不应排除临床诊断。

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