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臂丛的解剖、影像学和病理学状况。

Anatomy, Imaging, and Pathologic Conditions of the Brachial Plexus.

机构信息

From the Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill (B.M.G., S.D.D.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Box 8131, St Louis, MO 63110 (M.S.P.).

出版信息

Radiographics. 2020 Oct;40(6):1686-1714. doi: 10.1148/rg.2020200012.

Abstract

The brachial plexus is an intricate anatomic structure with an important function: providing innervation to the upper extremity, shoulder, and upper chest. Owing to its complex form and longitudinal course, the brachial plexus can be challenging to conceptualize in three dimensions, which complicates evaluations in standard orthogonal imaging planes. The components of the brachial plexus can be determined by using key anatomic landmarks. Applying this anatomic knowledge, a radiologist should then be able to identify pathologic appearances of the brachial plexus by using imaging modalities such as MRI, CT, and US. Brachial plexopathies can be divided into two broad categories that are based on disease origin: traumatic and nontraumatic. In the traumatic plexopathy group, there are distinct imaging findings and management methods for pre- versus postganglionic injuries. For nontraumatic plexopathies, having access to an accurate patient history is often crucial. Knowledge of the timing of radiation therapy is critical to diagnosing post-radiation therapy brachial plexopathy. In acute brachial neuritis, antecedent stressors occur within a specific time frame. Primary and secondary tumors of the brachial plexus are not uncommon, with the most common primary tumors being peripheral nerve sheath tumors. Direct extension and metastasis from primary malignancies such as breast and lung cancer can occur. Although diagnosing a brachial plexus anomaly is potentially perplexing, it can be straightforward if it is based on foundational knowledge of anatomy, imaging findings, and pathologic features. RSNA, 2020.

摘要

臂丛是一种复杂的解剖结构,具有重要的功能:为上肢、肩部和胸部上部提供神经支配。由于其复杂的形态和纵行走行,臂丛在三维空间中难以想象,这使得在标准的正交成像平面上进行评估变得复杂。臂丛的各个组成部分可以通过使用关键的解剖学标志来确定。应用这种解剖学知识,放射科医生应该能够通过 MRI、CT 和 US 等成像方式识别臂丛的病理表现。臂丛神经病可分为基于病因的两大类:创伤性和非创伤性。在创伤性臂丛神经病组中,节前和节后损伤有明显的影像学表现和不同的处理方法。对于非创伤性臂丛神经病,获得准确的病史通常至关重要。了解放射治疗的时间对于诊断放射治疗后臂丛神经病至关重要。在急性臂神经炎中,应激源发生在特定的时间范围内。臂丛的原发性和继发性肿瘤并不少见,最常见的原发性肿瘤是外周神经鞘瘤。原发性恶性肿瘤如乳腺癌和肺癌可直接扩展和转移。虽然诊断臂丛异常具有潜在的复杂性,但如果基于解剖学、影像学表现和病理特征的基础知识,它可能会变得简单明了。RSNA,2020 年。

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