Ku Vanessa, Cox Cameron, Mikeska Andrew, MacKay Brendan
Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States.
Department of Orthopaedic Surgery, University Medical Center, Lubbock, Texas, United States.
J Brachial Plex Peripher Nerve Inj. 2021 May 14;16(1):e17-e23. doi: 10.1055/s-0041-1729176. eCollection 2021 Jan.
Peripheral nerve injuries (PNIs) continue to present both diagnostic and treatment challenges. While nerve transections are typically a straightforward diagnosis, other types of PNIs, such as chronic or traumatic nerve compression, may be more difficult to evaluate due to their varied presentation and limitations of current diagnostic tools. As a result, diagnosis may be delayed, and these patients may go on to develop progressive symptoms, impeding normal activity. In the past, PNIs were diagnosed by history and clinical examination alone or techniques that raised concerns regarding accuracy, invasiveness, or operator dependency. Magnetic resonance neurography (MRN) has been increasingly utilized in clinical settings due to its ability to visualize complex nerve structures along their entire pathway and distinguish nerves from surrounding vasculature and tissue in a noninvasive manner. In this review, we discuss the clinical applications of MRN in the diagnosis, as well as pre- and postsurgical assessments of patients with peripheral neuropathies.
周围神经损伤(PNIs)仍然在诊断和治疗方面存在挑战。虽然神经横断伤通常诊断较为直接,但其他类型的周围神经损伤,如慢性或创伤性神经受压,由于其表现多样以及当前诊断工具的局限性,可能更难评估。因此,诊断可能会延迟,这些患者可能会出现进行性症状,从而妨碍正常活动。过去,周围神经损伤仅通过病史和临床检查或一些在准确性、侵入性或操作者依赖性方面存在问题的技术来诊断。磁共振神经造影(MRN)因其能够沿神经的整个路径可视化复杂的神经结构,并以非侵入性方式将神经与周围血管和组织区分开来,而在临床环境中越来越多地得到应用。在本综述中,我们讨论了磁共振神经造影在周围神经病变患者的诊断以及术前和术后评估中的临床应用。