Anatomy, Imaging, and Pathologic Conditions of the Brachial Plexus
Anatomy, Imaging, and Pathologic Conditions of the Brachial Plexus
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DOI：
10.1148/rg.2020200012
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发表时间：
2020-10-01
期刊：
影响因子：
5.5
通讯作者：
Parsons, Matthew S.
中科院分区：
文献类型：
--
作者：
Gilcrease-Garcia, Brian M.;Deshmukh, Swati D.;Parsons, Matthew S.
臂丛神经是一种复杂的解剖结构，具有重要的功能：为上肢、肩部和上胸部提供神经支配。由于其复杂的形式和纵向路线，臂丛神经在三个维度上进行概念化可能具有挑战性，这使得标准正交成像平面中的评估变得复杂。臂丛神经的组成部分可以通过使用关键的解剖标志来确定。应用这些解剖知识，放射科医生应该能够通过使用 MRI、CT 和 US 等成像方式来识别臂丛神经的病理表现。根据疾病起源，臂丛神经病可分为两大类：创伤性和非创伤性。在创伤性神经丛病组中，节前损伤与节后损伤有不同的影像学表现和治疗方法。对于非创伤性神经丛病，了解准确的患者病史通常至关重要。了解放射治疗的时机对于诊断放射治疗后臂丛神经病至关重要。在急性臂神经炎中，先前的应激源发生在特定的时间范围内。臂丛神经的原发性和继发性肿瘤并不少见，最常见的原发性肿瘤是周围神经鞘瘤。乳腺癌和肺癌等原发性恶性肿瘤可能会发生直接扩展和转移。尽管诊断臂丛神经异常可能令人困惑，但如果基于解剖学、影像学表现和病理特征的基础知识，诊断可能会很简单。 (C) 北美放射学会，2020
The brachial plexus is an intricate anatomic structure with an important function: providing innervation to the upper extremity, shoulder, and upper chest. Owing to its complex form and longitudinal course, the brachial plexus can be challenging to conceptualize in three dimensions, which complicates evaluations in standard orthogonal imaging planes. The components of the brachial plexus can be determined by using key anatomic landmarks. Applying this anatomic knowledge, a radiologist should then be able to identify pathologic appearances of the brachial plexus by using imaging modalities such as MRI, CT, and US. Brachial plexopathies can be divided into two broad categories that are based on disease origin: traumatic and nontraumatic. In the traumatic plexopathy group, there are distinct imaging findings and management methods for pre- versus postganglionic injuries. For nontraumatic plexopathies, having access to an accurate patient history is often crucial. Knowledge of the timing of radiation therapy is critical to diagnosing post-radiation therapy brachial plexopathy. In acute brachial neuritis, antecedent stressors occur within a specific time frame. Primary and secondary tumors of the brachial plexus are not uncommon, with the most common primary tumors being peripheral nerve sheath tumors. Direct extension and metastasis from primary malignancies such as breast and lung cancer can occur. Although diagnosing a brachial plexus anomaly is potentially perplexing, it can be straightforward if it is based on foundational knowledge of anatomy, imaging findings, and pathologic features. (C) RSNA, 2020