“米袋法”在磁共振3D Nerve VIEW臂丛神经根成像中的应用

Clinical application of “rice bag method” in 3D Nerve VIEW brachial plexus root imaging

关键词:  臂丛神经  MRI  磁场均匀度

Key words:  brachial plexus  magnetic resonance imaging (MRI)  magnetic field uniformity

摘要:

目的 探讨"米袋法"在磁共振3D Nerve VIEW臂丛神经根检查中的应用。方法 使用3.0T MR对22名健康志愿者和28名臂丛损伤患者采用3D Nerve VIEW进行MR臂丛神经检查，均分别进行常规和加用米袋两次扫描，对健康志愿者和患者的磁共振图像进行分析。测量比较健康志愿者加米袋前后臂丛神经节的图像信噪比（signal to noise ratio，SNR）和对比噪声比（contrast to noise ratio，CNR）；采用4分法对臂丛显示情况进行主观评分，对成像质量的差异性进行统计学分析。根据臂丛损伤患者术中探查结果，计算加米袋前后臂丛损伤的检出率。结果 加米袋前臂丛神经SNR为1.90±0.66，CNR为14.27±6.82，加米袋后SNR为2.70±0.88，CNR为20.00±6.83，两者有显著差异（P<0.05）。主观评分由2.45±0.64提高到3.96±0.95，P<0.05。臂丛损伤患者加用米袋后臂丛神经损伤诊断的检出准确率由69.7%提高至81.8%。结论 "米袋法"可在臂丛神经根成像中显著提高SNR、CNR，提高臂丛神经成像质量，提高臂丛损伤的检出率，有较好的临床应用价值。

Abstract:

Objective To explore the application of "rice bag method" in MRI 3D Nerve VIEW for brachial plexus root examination. Methods Twenty-two healthy volunteers and 28 patients with brachial plexus injury were examined by using 3.0T MR with 3D Nerve VIEW. MRI images of healthy volunteers and patients were analyzed by using conventional and rice bag scanning respectively. Image signal to noise ratio (SNR) and contrast to noise ratio (CNR) of the brachial plexus ganglion before and after adding rice bag were measured in healthy volunteers. The 4-point method was used to score the brachial plexus display subjectively, and the difference of imaging quality was statistically analyzed. The detection rate of brachial plexus injury before and after adding rice bag was calculated according to the results of intraoperative exploration in patients with brachial plexus injury. Results The SNR and CNR of brachial plexus were 1.90±0.66 and 14.27±6.82 respectively before the rice bag, and 2.70±0.88 and 20.00±6.83 respectively after the rice bag, showing significant differences (P<0.05). The subjective score increased from 2.45±0.64 to 3.96±0.95 (P<0.05). The diagnostic accuracy of brachial plexus injury was increased from 69.7% to 81.8% after the addition of rice bag. Conclusion The "rice bag method" can significantly improve SNR and CNR, imaging quality of brachial plexus, and detection rate of brachial plexus injury in the imaging of brachial plexus root, which has good clinical application value.