【摘要】：研究背景 臂叢損傷伴隨著交通事故的發(fā)生日趨增多,致殘率高,給患者及其家庭和社會帶來了一定程度的負(fù)擔(dān),同時臂叢神經(jīng)損傷的診治目前仍十分棘手,隨著微創(chuàng)甚至無創(chuàng)診斷技術(shù)要求的不斷提高而使得無創(chuàng)性診斷成為必須。有關(guān)臂叢神經(jīng)損傷的臨床研究方面國內(nèi)外報道較多,脊髓造影(Myelography)、計(jì)算機(jī)斷層脊髓造影(computerized tomography myelography,CTM)和MRI是術(shù)前主要的診斷手段。CT具有較好地顯示骨骼系統(tǒng)的特性,但CT對軟組織分辨率較低,很難區(qū)分周圍神經(jīng)與肌肉等軟組織,因而無法直接顯示周圍神經(jīng)損傷的情況,而且CT僅僅能做橫斷掃描,只能從一個方位觀察。脊髓造影是通過頸椎或腰椎穿刺將造影劑經(jīng)椎間隙注入蛛網(wǎng)膜下腔中,用于診斷椎管內(nèi)病變和硬脊膜有無破裂。臂叢根性撕脫傷時脊髓造影可以清楚的顯示神經(jīng)斷裂、硬脊膜囊破裂、膨出等。目前對臂叢神經(jīng)的診斷多在脊髓造影后行CT檢查,即CTM,這對臂叢根性撕脫傷有重要意義,但CTM屬于有創(chuàng)檢查。MRI作為一種無損傷診斷技術(shù),不用造影劑便能對臂叢節(jié)前和節(jié)后損傷作出判斷,消除了CTM和脊髓造影存在的X線輻射、造影劑副作用、椎管穿刺技術(shù)、骨骺偽影等缺點(diǎn),其珍斷準(zhǔn)確性、病變檢出率均優(yōu)于脊髓造影和CTM,同時彌補(bǔ)了脊髓造影和CTM只能提供節(jié)前損傷診斷信息的不足。由于MRI反響時間較長,而且不能總是很清楚地顯
[Abstract]:Background the brachial plexus injury is accompanied by the increasing number of traffic accidents and the high rate of disability, which brings a certain degree of burden to the patients and their families and society. At the same time, the diagnosis and treatment of brachial plexus injury is still very difficult. There are many reports on the clinical study of brachial plexus injury. Myelography (computerized tomography myelography,CTM) and MRI (Myelography), computed tomography myelography) are the main diagnostic methods before operation. CT has the characteristics of showing the skeletal system well. But because of the low resolution of soft tissue in CT, it is difficult to distinguish the peripheral nerve from muscle, so it can not directly show the injury of the peripheral nerve. Moreover, CT can only do cross-sectional scanning and can only be observed from one direction. Myelography is a method of injecting contrast media into the subarachnoid space through cervical or lumbar puncture to diagnose spinal canal lesions and the rupture of dura mater. Myelography of brachial plexus root avulsion can clearly show nerve rupture, rupture of dural sac, bulge and so on. At present, most of the diagnosis of brachial plexus nerve is performed CT examination after myelography, that is, CTM, is of great significance for brachial plexus root avulsion injury, but CTM belongs to invasive examination. MRI is a noninvasive diagnostic technique. Without contrast agent, we can judge the injury of brachial plexus preganglionic and postganglionic, eliminate the shortcomings of X-ray radiation, contrast agent side effect, spinal canal puncture technique, epiphyseal artifact and so on, which exist in CTM and myelography. The detectable rate of lesion was better than that of myelography and CTM,. Both myelography and CTM could only provide the diagnostic information of preganglionic injury. Because the MRI response time is long, and not always very clea
【學(xué)位授予單位】：第一軍醫(yī)大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2005
【分類號】：R651.3;R322

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 漆光平,姜平,徐煥俐;人體斷層標(biāo)本制作法[J];湖南醫(yī)科大學(xué)學(xué)報;1999年02期

2 張紹祥，劉正津，何光篪，徐美和，，唐澤圣;生物塑化薄層連續(xù)斷面的計(jì)算機(jī)三維重建[J];解剖學(xué)報;1996年02期

3 梁銀杏,勞鎮(zhèn)國,戚劍,呂建敏;肌電圖與MRI檢查結(jié)合診斷臂叢神經(jīng)損傷的研究[J];現(xiàn)代電生理學(xué)雜志;2001年03期

4 顧立強(qiáng),王鋼,裴國獻(xiàn);骨盆骨折與腰骶叢損傷[J];中國創(chuàng)傷骨科雜志;2001年02期

5 顧立強(qiáng),陳國奮,相大勇,朱立軍,裴國獻(xiàn);免疫抑制劑FK506加速周圍神經(jīng)損傷修復(fù)后功能恢復(fù)的初步臨床報告[J];中國創(chuàng)傷骨科雜志;2001年03期

6 陳國奮,顧立強(qiáng);FK506加速周圍神經(jīng)損傷修復(fù)后肢體功能恢復(fù)的實(shí)驗(yàn)研究[J];中國創(chuàng)傷骨科雜志;2001年04期

7 高明勇,梁碧玲,許揚(yáng)濱,黃穗喬,鐘鏡聯(lián),陳健宇,葉瑞心;臂叢神經(jīng)根損傷的MR診斷及其應(yīng)用價值[J];中華創(chuàng)傷雜志;1999年02期

8 常萬紳,諸寅,李玉成,沈成,張?jiān)茲?王海華;神經(jīng)束移位治療臂叢神經(jīng)根性撕脫傷70例臨床報告[J];中華手外科雜志;2000年04期

9 張連波,高慶國,王國君;放射性臂叢神經(jīng)損傷的研究進(jìn)展[J];中華手外科雜志;2002年03期

10 史其林,顧玉東;在胸腔內(nèi)窺鏡鏡視下切取膈神經(jīng)的實(shí)驗(yàn)研究[J];中華手外科雜志;1999年02期

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