Leigheb Massimiliano, Tricca Stefano, Percivale Ilaria, Licandro Davide, Paladini Andrea, Barini Michela, Guzzardi Giuseppe, Grassi Federico A, Stecco Alessandro, Carriero Alessandro
Orthopaedics and Traumatology Unit, "Maggiore della carità" Hospital, Department of Health Sciences, University of Piemonte Orientale (UPO), Via Solaroli 17, 28100 Novara, Italy.
Department of Diagnosis and Treatment Services, Radiodiagnostics, "Maggiore della carità" Hospital, University of Piemonte Orientale (UPO), Via Solaroli 17, 28100 Novara, Italy.
Brain Sci. 2021 Jan 30;11(2):173. doi: 10.3390/brainsci11020173.
Traumatic brachial plexus injuries are rare but serious consequences of major traumas. Pre-ganglionic lesions are considered irreparable, while post-ganglionic injuries can be potentially treated if an early diagnosis is available. Pre-surgical diagnosis is important to distinguish low-grade from high-grade lesions and to identify their location. The aim of the review is to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the identification of adult post-ganglionic lesions due to traumatic brachial plexus injuries, compared to intraoperative findings.
Research on the main scientific electronic databases was conducted. Studies of adults with traumatic post-ganglionic brachial plexus injuries were included. The index test was preoperative MRI and the reference standard was surgical exploration. Pooled sensitivity and specificity were calculated.
Four studies were included for the systematic review, of which three articles met the inclusion criteria for the meta-analysis. Pooled sensitivity and pooled specificity values resulted high. The sensitivity value is associated with a high heterogeneity index of the selected literature.
MRI can be considered, despite the limits, the gold standard exam in morphological evaluation of brachial plexus injuries, particularly in the diagnosis of post-ganglionic traumatic injuries.
创伤性臂丛神经损伤虽罕见，但却是重大创伤的严重后果。节前损伤被认为无法修复，而节后损伤若能早期诊断则有可能得到治疗。术前诊断对于区分低度和高度损伤以及确定其位置至关重要。本综述的目的是评估磁共振成像（MRI）在识别成人创伤性臂丛神经损伤所致节后损伤方面的诊断准确性，并与术中发现进行比较。
对主要科学电子数据库进行了研究。纳入了关于成人创伤性节后臂丛神经损伤的研究。索引测试为术前MRI，参考标准为手术探查。计算合并敏感性和特异性。
纳入了四项研究进行系统评价，其中三篇文章符合荟萃分析的纳入标准。合并敏感性和合并特异性值较高。敏感性值与所选文献的高异质性指数相关。
尽管存在局限性，MRI仍可被视为臂丛神经损伤形态学评估的金标准检查，尤其是在节后创伤性损伤的诊断中。
