臂丛神经炎还是神经炎？帕森特纳综合征病变分布的 MRI 特征。
Brachial plexitis or neuritis? MRI features of lesion distribution in Parsonage-Turner syndrome.
机构信息
Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th Street, New York, New York, 10021, USA.
College of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.
出版信息
Muscle Nerve. 2018 Sep;58(3):359-366. doi: 10.1002/mus.26108. Epub 2018 Mar 25.
INTRODUCTION
This study seeks to characterize lesion distribution in Parsonage-Turner Syndrome (PTS) using high-resolution MRI.
METHODS
MRIs of 27 patients with clinically confirmed PTS were reviewed. Two radiologists independently evaluated the brachial plexus proper, side and terminal plexus branches, and more distal, upper extremity nerves.
RESULTS
All patients had at least 1 clinically involved nerve. MRI revealed that the plexus appeared normal in 24 of 27 patients; in 3 other patients, signal hyperintensity was seen immediately proximal to the take-off of abnormal side or terminal branch nerves. Focal intrinsic constrictions were detected in 32 of 38 nerves. MRI interobserver agreement was high (Cohen's κ = 0.839).
DISCUSSION
MRI findings, corroborated by electrodiagnostic testing, localized abnormalities to plexus branches and peripheral nerves, suggesting that PTS is characterized by 1 or more mononeuropathies rather than changes involving a portion of or the complete plexus proper. These results may improve diagnosis, prognostication, and management. Muscle Nerve 58: 359-366, 2018.
简介
本研究旨在利用高分辨率 MRI 来描述Parsonage-Turner 综合征（PTS）的病变分布。
方法
回顾了 27 例经临床证实的 PTS 患者的 MRI。两位放射科医生独立评估臂丛神经、侧支和终末支分支以及更远端的上肢神经。
结果
所有患者均至少有 1 条临床受累神经。MRI 显示，27 例患者中有 24 例丛外观正常；另外 3 例患者，在异常侧支或终末支神经起始处近端可见信号增强。在 38 条神经中，有 32 条检测到局灶性固有狭窄。MRI 的观察者间一致性很高（Cohen's κ=0.839）。
讨论
MRI 发现，结合电诊断测试，将异常局限于丛支和周围神经，提示 PTS 的特征是 1 个或多个单神经病，而不是涉及部分或整个丛的改变。这些结果可能会改善诊断、预后和治疗。肌肉神经 58:359-366, 2018。
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