Collins J D, Disher A C, Miller T Q
Department of Radiological Sciences, UCLA School of Medicine 90024-1721, USA.
J Natl Med Assoc. 1995 Jul;87(7):489-98.
Full field of view coronal chest magnetic resonance imaging (MRI) routinely displays bilateral images of the brachial plexus, surface anatomy, and anatomic structures. Eighty patients had chest radiographs correlated with surgery for thoracic outlet syndrome. The PA chest film findings correlated with the surgical findings: smaller thoracic inlet on the concave side of the cervicothoracic spine scoliosis, shorter distance between the dorsal spine of the second or third thoracic vertebral body to the concavity of the first ribs, asymmetric clavicles and coracoid processes, synchondrosis of the first and second ribs, and muscle atrophy on the side of the clinical complaints. More than 235 patients were imaged. One hundred sixty-five of these were imaged with a 1.5-T unit and 3-D reconstruction MRI. Coronal, transverse (axial), oblique transverse, and sagittal plane T1-weighted, selected T2-weighted, and fast spine echo pulse sequences were obtained, 4- to 5-mm slice thickness, 40 to 45 cm full field of view, 512 x 256 matrix and 2 NEX. Two-dimensional time of flight (2D TOF), magnetic resonance angiography (MRA) sequences were obtained in selected patients. Coronal, transverse, and sagittal sequences were reformatted for evaluation. Saline water bags were placed between the neck and thorax to enhance the signal-to-noise ratio. Compromising abnormalities of the brachial plexus were confirmed at surgery. Compromise of the neurovascular supply seemed to be one etiology that could be demonstrated. The clinical history, technique, and anatomic bilateral brachial plexus imaging is stressed to improve patient care. The cervical rib is one of the compromising brachial plexopathies selected for this presentation.
全视野冠状位胸部磁共振成像（MRI）通常可显示臂丛神经、表面解剖结构和解剖学结构的双侧图像。80例患者的胸部X光片与胸廓出口综合征手术结果相关。后前位胸部X线片结果与手术结果相关：在颈胸段脊柱侧弯凹侧的胸廓入口较小，第二或第三胸椎椎体棘突至第一肋骨凹面的距离较短，锁骨和喙突不对称，第一和第二肋骨的软骨结合，以及临床症状侧的肌肉萎缩。超过235例患者接受了成像检查。其中165例采用1.5-T设备和三维重建MRI进行成像。获取了冠状位、横断（轴位）、斜横断和矢状位平面的T1加权、选定的T2加权和快速脊柱回波脉冲序列，层厚4至5毫米，全视野40至45厘米，矩阵为512×256，激励次数为2次。部分患者还获取了二维时间飞跃（2D TOF）磁共振血管造影（MRA）序列。对冠状位、横断位和矢状位序列进行了重新格式化以进行评估。在颈部和胸部之间放置盐水袋以提高信噪比。手术证实了臂丛神经存在受压异常。神经血管供应受压似乎是一种可被证实的病因。强调临床病史、技术以及双侧臂丛神经解剖成像，以改善患者护理。颈肋是本次报告中选定的导致臂丛神经病变的受压因素之一。
