臂丛神经影像形态学和虚拟中国人女Ⅰ号臂丛、腰骶丛神经断层解剖学及可视化初步研究

发布时间：2019-02-17 13:13

【摘要】：研究背景臂丛损伤伴随着交通事故的发生日趋增多,致残率高,给患者及其家庭和社会带来了一定程度的负担,同时臂丛神经损伤的诊治目前仍十分棘手,随着微创甚至无创诊断技术要求的不断提高而使得无创性诊断成为必须。有关臂丛神经损伤的临床研究方面国内外报道较多,脊髓造影(Myelography)、计算机断层脊髓造影(computerized tomography myelography,CTM)和MRI是术前主要的诊断手段。CT具有较好地显示骨骼系统的特性,但CT对软组织分辨率较低,很难区分周围神经与肌肉等软组织,因而无法直接显示周围神经损伤的情况,而且CT仅仅能做横断扫描,只能从一个方位观察。脊髓造影是通过颈椎或腰椎穿刺将造影剂经椎间隙注入蛛网膜下腔中,用于诊断椎管内病变和硬脊膜有无破裂。臂丛根性撕脱伤时脊髓造影可以清楚的显示神经断裂、硬脊膜囊破裂、膨出等。目前对臂丛神经的诊断多在脊髓造影后行CT检查,即CTM,这对臂丛根性撕脱伤有重要意义,但CTM属于有创检查。MRI作为一种无损伤诊断技术,不用造影剂便能对臂丛节前和节后损伤作出判断,消除了CTM和脊髓造影存在的X线辐射、造影剂副作用、椎管穿刺技术、骨骺伪影等缺点,其珍断准确性、病变检出率均优于脊髓造影和CTM,同时弥补了脊髓造影和CTM只能提供节前损伤诊断信息的不足。由于MRI反响时间较长,而且不能总是很清楚地显
[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
【学位授予单位】：第一军医大学
【学位级别】：博士
【学位授予年份】：2005
【分类号】：R651.3;R322

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