Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders Clinical article
Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders Clinical article
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DOI：
10.3171/2009.7.jns09414
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发表时间：
2010-02-01
影响因子：
4.1
通讯作者：
Weinstein, Philip R.
中科院分区：
文献类型：
--
作者：
Du, Rose;Auguste, Kurtis I.;Weinstein, Philip R.
对象。脊髓和周围神经病变的治疗依赖于通过使用神经学检查、脊髓MR成像和肌电图(EMG)/神经传导研究（NCSs）来定位病理。磁共振神经成像（MRN）是近年来发展起来的一种用于脊髓和周围神经直接成像的新型成像技术。在本研究中，作者分析了核磁共振成像在评估脊髓和周围神经病变中的作用。对1999年3月至2005年2月期间在加州大学旧金山分校接受mri检查的191例脊髓和周围神经疾病患者的影像学研究、医疗记录和EMG/NCS结果进行回顾性分析。其中91例（47.6%）患者还进行了肌电图/NCS检查。在同时接受MRN和EMG/NCS的患者中，MRN分别提供了32%和45%的相同或额外的诊断信息。在症状出现后的中位12个月获得磁共振神经图。MRN的效用与症状发作到MRN的时间间隔相关。12例患者接受重复核磁共振成像进行系列评估。在后续MRN上检测到的异常信号的减少与症状出现的时间和MRN之间的时间间隔相关，但与症状的缓解无关。21例患者术后行MRN评估持续、复发或新发症状；其中3例（14.3%）需要后续手术。在评估和定位神经根、臂丛和周围神经病变方面，磁共振神经造影是传统MR成像和EMG/NCS的重要辅助手段。作者发现，MRN适用于以下患者：1)肌电图和传统MR成像不确定的患者；2)既往接受过臂丛区放射治疗的臂丛病患者；3)有臂丛病和全身性肿瘤者；4)周围神经病变或创伤后考虑手术的患者。磁共振神经造影受神经干成像的大小和研究时间的限制。(DOI: 10.3171 / 2009.7.jns09414)
Object. Treatment of spinal and peripheral nerve lesions relies on localization of the pathology by the use of neurological examination, spinal MR imaging and electromyography (EMG)/nerve conduction studies (NCSs). Magnetic resonance neurography (MRN) is a novel imaging technique recently developed for direct imaging of spinal and peripheral nerves. In this study, the authors analyzed the role of MRN in the evaluation of spinal and peripheral nerve lesions.Methods. Imaging studies, medical records, and EMG/NCS results were analyzed retrospectively in a consecutive series of 191 patients who underwent MRN for spinal and peripheral nerve disorders at the University of California, San Francisco between March 1999 and February 2005. Ninety-one (47.6%) of these patients also underwent EMG/NCS studies.Results. In those who underwent both MRN and EMG/NCS, MRN provided the same or additional diagnostic information 32 and 45% of patients, respectively. Magnetic resonance neurograms were obtained at a median of 12 months after the onset of symptoms. The utility of MRN correlated with the interval between the onset of symptoms to MRN. Twelve patients underwent repeated MRN for serial evaluation. The decrease in abnormal signal detected On Subsequent MRN correlated with time from onset of symptoms and the time interval between MRN, but not with resolution of symptoms. Twenty-one patients underwent MRN postoperatively to assess persistent, recurrent, or new symptoms; of these 3 (14.3%) required a subsequent surgery.Conclusions. Magnetic resonance neurography is a valuable adjunct to conventional MR imaging and EMG/NCS in the evaluation and localization of nerve root, brachial plexus, and peripheral nerve lesions. The authors found that MRN is indicated in patients: 1) in whom EMG and traditional MR imaging are inconclusive; 2) who present with brachial plexopathy who have previously received radiation therapy to the brachial plexus region; 3) who present with brachial plexopathy and have systemic tumors; and 4) in patients under consideration for surgery for peripheral nerve lesions or after trauma. Magnetic resonance neurography is limited by the size of the nerve trunk imaged and the timing of the study. (DOI: 10.3171/2009.7.JNS09414)