Department of Neuroradiology, University Medical Center Schleswig Holstein Lübeck Campus, Lübeck, Germany.
Institute of System Motor Science, University Medical Center Schleswig Holstein Lübeck Campus, Lübeck, Germany.
Eur J Pediatr Surg. 2023 Aug;33(4):319-327. doi: 10.1055/s-0042-1751221. Epub 2022 Jul 19.
Fractures of the upper extremity are common traumatic injuries in children. Nerve lesions are a rare but typical complication of these fractures. Additional to physical, electrophysiological, and sonographic examinations, magnetic resonance neurography (MRN) can be used to assess the degree and exact localization of nerve damage. This retrospective study was conducted to evaluate the potential role of this examination technique for children and to test a proposed MRN classification of traumatic nerve injury according to Chhabra in a pediatric cohort.
Pediatric patients undergoing MRN for traumatic nerve injury from January 2016 to December 2020 were retrospectively identified. A total of 12 consecutive patients with sufficient clinical data, an MRN, and if available follow-up examination were enrolled and analyzed.
In 10 of 12 cases one or more nerve lesions could be identified by MRN using the classification proposed by Chhabra et al. MRN was used to assess nerve injuries, imaging results were compared with clinical course. Clinical follow-up examinations of 10 patients showed an overall good clinical recovery, even in one case with severe trauma and nerve surgery.
MRN as a noninvasive procedure can help in the evaluation of nerve injury, especially for the identification of lower grade nerve damage and to objectify suspected nerve damage in case of uncertain clinical examination results; thus, can help in decision making whether surgical revision or conservative treatment is preferable.
上肢骨折是儿童常见的外伤性损伤。神经损伤是这些骨折的一种罕见但典型的并发症。除了物理、电生理和超声检查外，磁共振神经成像（MRN）可用于评估神经损伤的程度和确切位置。本回顾性研究旨在评估该检查技术对儿童的潜在作用，并在儿科患者中测试 Chhabra 提出的创伤性神经损伤的 MRN 分类。
回顾性确定了 2016 年 1 月至 2020 年 12 月因创伤性神经损伤而接受 MRN 的儿科患者。共纳入并分析了 12 例具有足够临床资料、MRN 检查和（如有）随访检查的连续患者。
在 12 例患者中的 10 例中，Chhabra 等人提出的分类可通过 MRN 识别出一个或多个神经病变。MRN 用于评估神经损伤，将影像学结果与临床病程进行比较。10 例患者的临床随访检查显示整体临床恢复良好，即使在一例严重创伤和神经手术的情况下也是如此。
作为一种非侵入性的程序，MRN 可帮助评估神经损伤，特别是识别较低等级的神经损伤，并在临床检查结果不确定的情况下客观怀疑神经损伤；因此，可以帮助决定是否需要手术修正或保守治疗。
