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神经痛性肌萎缩症:磁共振神经成像诊断的敏感性和特异性:一项回顾性研究。

Neuralgic amyotrophy: sensitivity and specificity of magnetic resonance neurography in diagnosis: A retrospective study.

机构信息

Department of Radiology, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei, China.

出版信息

Medicine (Baltimore). 2023 Oct 27;102(43):e35527. doi: 10.1097/MD.0000000000035527.

Abstract

BACKGROUND

Neuralgic amyotrophy (NA) is a clinically acute or subacute disease. To study the characteristics of brachial plexus magnetic resonance neurography (MRN) in patients with NA, and to explore the clinical application value of MRN combined with electromyography (EMG) in the diagnosis of NA.

METHODS

Brachial plexus MRN images of 32 patients with NA were retrospectively analyzed, and their characteristics were investigated. The accuracy, sensitivity and specificity of MRN, EMG, and the combination of the 2 methods for NA diagnosis were compared.

RESULTS

Among the 32 patients with NA, 28 (87.5%) cases of unilateral brachial plexus involvement, 18 (56.3%) cases of multiple nerve roots involvement. In 10 cases, C5 nerve roots were involved alone, and in 9 cases, C5 to C6 nerve roots were involved together. The T2 signal intensity of the affected nerve increased, and 19 cases showed thickened and smooth nerve root edges. Twelve cases showed uneven thickening and segmental stenosis of the involved nerve roots. The diagnostic accuracy, sensitivity, and specificity of MRN for NA were higher than those of EMG. Combining MRN and EMG could improve the sensitivity and specificity of diagnosis.

CONCLUSION

The main feature of MRN in patients with NA was that it was unilateral brachial plexus asymmetric involvement. The diagnostic effect of MRN was better than that of EMG. The combined diagnosis of MRN and EMG can help clinicians diagnose NA accurately.

摘要

背景

神经痛性肌萎缩(NA)是一种临床急性或亚急性疾病。研究 NA 患者臂丛磁共振神经成像(MRN)的特点,探讨 MRN 联合肌电图(EMG)在 NA 诊断中的临床应用价值。

方法

回顾性分析 32 例 NA 患者的臂丛 MRN 图像,探讨其特征。比较 MRN、EMG 及两者联合对 NA 诊断的准确性、敏感性和特异性。

结果

32 例 NA 患者中,28 例(87.5%)单侧臂丛受累,18 例(56.3%)多神经根受累。10 例单纯 C5 神经根受累,9 例 C5~C6 神经根同时受累。受累神经的 T2 信号强度增高,19 例神经根边缘增厚光滑。12 例受累神经根不均匀增粗,呈节段性狭窄。MRN 对 NA 的诊断准确性、敏感性和特异性均高于 EMG。MRN 联合 EMG 可提高诊断的敏感性和特异性。

结论

NA 患者 MRN 的主要特征是单侧臂丛神经不对称受累。MRN 的诊断效果优于 EMG。MRN 与 EMG 的联合诊断有助于临床医生准确诊断 NA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0802/10615388/e364022744ca/medi-102-e35527-g001.jpg

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