Ochi M, Ikuta Y, Watanabe M, Kimori K, Itoh K
Department of Orthopaedic Surgery, Hiroshima University School of Medicine, Japan.
J Hand Surg Br. 1994 Feb;19(1):55-9. doi: 10.1016/0266-7681(94)90050-7.
Findings in 34 patients with traumatic brachial plexus injury documented by surgical exploration and intra-operative somatosensory-evoked potentials were correlated with findings on myelography and magnetic resonance imaging (MRI) to determine whether MRI can identify nerve root avulsion. The coronal and sagittal planes were not able to demonstrate avulsion of the individual nerve roots. The axial and axial oblique planes did provide useful information to determine which nerve root was avulsed in the upper plexus, although it was difficult to clearly delineate the lower cervical rootlets. The accuracy of MRI was 73% for C5 and 64% for C6 and that of myelography 63% for C5 and 64% for C6. Thus, the diagnostic accuracy of MRI for upper nerve roots was slightly superior to myelography. Although its primary diagnostic value is limited to the upper nerve roots whose avulsion is relatively difficult to diagnose by myelography, MRI can provide useful guidance in the waiting period prior to surgical exploration after brachial plexus injury.
通过手术探查和术中体感诱发电位记录的34例创伤性臂丛神经损伤患者的检查结果，与脊髓造影和磁共振成像（MRI）的结果相关联，以确定MRI是否能够识别神经根撕脱。冠状面和矢状面无法显示单个神经根的撕脱情况。轴位和轴斜位平面确实提供了有用信息，以确定上丛中哪个神经根发生了撕脱，尽管很难清晰地描绘出下颈神经根丝。MRI对C5的诊断准确率为73%，对C6的诊断准确率为64%；脊髓造影对C5的诊断准确率为63%，对C6的诊断准确率为64%。因此，MRI对上神经根的诊断准确性略优于脊髓造影。尽管其主要诊断价值仅限于那些通过脊髓造影相对难以诊断撕脱情况的上神经根，但MRI在臂丛神经损伤后的手术探查前的等待期可以提供有用的指导。
