Magnetic resonance imaging of obstetrical brachial plexus injuries
Magnetic resonance imaging of obstetrical brachial plexus injuries
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DOI：
10.1007/s00381-004-1003-6
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发表时间：
2004-10-01
影响因子：
1.4
通讯作者：
Lefton, D
中科院分区：
文献类型：
--
作者：
Abbott, R;Abbott, M;Lefton, D
目的：回顾婴幼儿Erb麻痹的MR影像学表现。目的是确定磁共振成像在预测这些婴儿手术结果方面的有效性。方法：15例患者（平均年龄14.5个月）行臂丛手术探查。所有患者术前均使用GE (Milwaukee， WI， USA) 1.5-Tesla MRI进行MR成像，并与儿童手术记录中概述的手术结果相关联。结果：15例患者影像学检查中，8例（53.3%）存在至少1个假性脑膜膨出，3例（20%）存在多发假性脑膜膨出。后肩半脱位11例（73.3%）。14名儿童（93.3%）有影像学异常，符合修复性神经瘤或神经丛成分瘢痕组织。我们无法通过磁共振成像来区分两者。在手术中，11例（73.3%）患者发现瘢痕组织包裹C5 - C6根、上干和/或外侧和后束，4例患者有修复性神经瘤。2例患者同时有瘢痕组织和修复性神经瘤。所有15例患者（100%）均发现瘢痕组织或神经瘤。结论：磁共振成像是显示臂丛病变的有效工具，值得手术探查。
Objective: We reviewed MR imaging in infants with Erb's palsy. The goal was to determine the effectiveness of MR imaging in predicting operative findings for these infants. Methods: Fifteen patients ( mean age: 14.5 months) underwent surgical exploration of the brachial plexus. Preoperative MR imaging was acquired in all patients with a GE ( Milwaukee, WI, USA) 1.5-Tesla MRI and correlated with the surgical findings as outlined in the children's operative notes. Results: Through imaging, the presence of at least one pseudomeningocele was found in 8 of the 15 patients (53.3%) while 3 of the 15 patients (20%) had multiple pseudomeningoceles. Posterior shoulder subluxation was seen in 11 patients (73.3%). Fourteen children (93.3%) had imaging abnormalities consistent with either a reparative neuroma or scar tissue investing plexus elements. We were unable to differentiate between the two with MR imaging. At surgery, scar tissue was found entrapping the C5 - C6 roots, upper trunk, and/ or lateral and posterior cords in 11 patients (73.3%) while 4 patients had reparative neuromas. Two patients had both entrapment by scar tissue and a reparative neuroma. Either entrapment by scar tissue or neuroma was found in all 15 patients (100%). Conclusions: MR imaging is an effective tool for demonstrating lesions of the brachial plexus worthy of surgical exploration.