Gasparotti R, Ferraresi S, Pinelli L, Crispino M, Pavia M, Bonetti M, Garozzo D, Manara O, Chiesa A
Department of Radiology, University of Brescia, Italy.
AJNR Am J Neuroradiol. 1997 Oct;18(9):1733-42.
To determine the diagnostic accuracy of three-dimensional MR myelography in the evaluation of traumatic injuries of the brachial plexus.
Twenty patients with clinical and electromyographic evidence of traumatic brachial plexopathy were examined with three-dimensional MR myelography, conventional cervical myelography, and CT myelography 1 to 9 months after trauma. Three-dimensional MR myelography was performed on a 1.5-T MR unit with a constructive interference in steady state (CISS) technique. For each patient, maximum intensity myelographic projections and multiplanar reconstruction reformatted 1-mm axial sections were obtained from the same 3-D data set. Three-dimensional MR myelographic findings were compared with findings at cervical myelography and CT myelography. Surgical findings were available for comparison in 13 patients.
Three-dimensional MR myelography enabled detection of meningoceles with avulsed or intact nerve roots, partial or complete radicular avulsions without disruption of the thecal sac, dural sleeve abnormalities, and dural scars. Assuming cervical myelography and CT myelography as the standards of reference, 3-D MR myelography showed 89% sensitivity, 95% specificity, and 92% diagnostic accuracy in the evaluation of nerve root integrity.
Three-dimensional MR myelography can show the majority of traumatic lesions that involve the proximal portion of the brachial plexus in a single rapid examination. On the basis of our findings, we propose this technique as a screening examination for patients with traumatic brachial plexus palsy.
确定三维磁共振脊髓造影在评估臂丛神经创伤性损伤中的诊断准确性。
对20例有创伤性臂丛神经病变临床及肌电图证据的患者，在创伤后1至9个月进行三维磁共振脊髓造影、传统颈椎脊髓造影和CT脊髓造影检查。三维磁共振脊髓造影在1.5-T磁共振单元上采用稳态构成干扰（CISS）技术进行。对于每位患者，从同一三维数据集中获取最大强度脊髓造影投影和多平面重建的1毫米轴向切片。将三维磁共振脊髓造影结果与颈椎脊髓造影和CT脊髓造影结果进行比较。13例患者有手术结果可供比较。
三维磁共振脊髓造影能够检测出伴有神经根撕脱或完整的脊膜膨出、硬脊膜囊未破裂的部分或完全神经根撕脱、硬脊膜袖异常和硬脊膜瘢痕。以颈椎脊髓造影和CT脊髓造影作为参考标准，三维磁共振脊髓造影在评估神经根完整性方面显示出89%的敏感性、95%的特异性和92%的诊断准确性。
三维磁共振脊髓造影能够在一次快速检查中显示出大多数累及臂丛神经近端的创伤性病变。基于我们的研究结果，我们建议将该技术作为创伤性臂丛神经麻痹患者的筛查检查。
