磁共振三維短時間反轉恢復序列對臂神經叢之應用

臂神經叢是由第5、6、7、8 對的頸椎神經及第一對胸椎神經所構成的複雜神經構造，它們共同支配著肩帶肌肉與上肢肌肉的活動和感覺；而人們的所有上肢動作與感覺神經，完全由臂神經叢所控制；因而當臂神經叢受傷或異常後，病患的生活上會出現極大的不便，包括無法用受傷的手臂從事日常的生活與工作等等。臂神經叢的生理結構非常複雜，若受傷型態為神經根完全斷裂，則復原機率渺茫，所以若有因臂神經叢受損而引起功能上殘障不便者，應及早就醫檢查，才能恢復患肢的功能。本研究目的就是要在使用施打美格維斯造影注射劑後，利用三維短時間反轉恢復序列掃描，再配合影像後處理，進行最大亮度投影和10-25mm的厚度行最大亮度投影之曲線平面重組，將臂神經叢全部投影出來，讓受損傷的位置及病變，或腫瘤大小和區域，清楚的顯示出來，使得臨床醫師更容易評估與判斷臂神經叢之病變，此技術因可區分腫瘤變形及侵潤的情形，將有助於外科手術與腫瘤治療計畫的處置。研究期間為期十個月，共收集17位疑似有臂叢神經損傷或病變的病患，其中男性有11位，女性有6位，而這些患者均能清楚且明確的，顯示臂神經叢的走向及構造，並將臂神經叢所患之病變—呈現出來。

關鍵字

臂神經叢；三維短時間反轉恢復序列；最大亮度投影

並列摘要

Brachial plexus is a delicate plexus structure that is constituted by 5th, 6th, 7th and 8th pair of cervical nerves and the 1st pair of thoracic nerves, and that controls the mechanisms and senses of the muscles in moving of shoulder girdle and of upper limbs, while all of the movement and sensory nerves of upper limbs of our human bodies are absolutely controlled by brachial plexus. Therefore, patients who are suffering from damages or disorder of brachial plexus will have to bear extreme inconveniences, including arms in dysfunction that fail to achieve normal daily life and work etc. The physical structure of brachial plexus is so delicate that its recovery chances are rare since the damages are in a form of absolute abruptness of its nerve root. The medical advices thus for such damages on brachial plexus that caused dysfunctions has always been early examination in hospitals for recoveries of the functions of limbs impacted by such damages. The purpose of our study is to express brachial plexus as possible by curve planar reconstruction (CPR) under maximum intensity projection (MIP) and 10-to-25mm-MIP thin slab projection, after image processes following scans of three dimensional short term inversion recovery (3D-STIR) after aids of Magnevist Gd-DTPA. As a result, we can practically show clear locations and pathological changes of damages as well as sizes and areas of swelling. By this study, we expected that clinical physicians could more easily make estimation and judgment on pathological changes of brachial plexus. The technique appears very important for surgical and oncologic planning as it is possible to differentiate deformation from infiltration. During the 10 months of our study, we in total collected 17 samples of patients who are in suspicions of damages or pathological changes of their brachial plexus, with 11 as males and 6 as females. Also, by our outcomes, we have clear and definite images for the routes and structures of the brachial plexus from all of our samples, and have successfully expressed the pathological changes in details.

並列關鍵字

Brachial Plexus ； 3D-STIR ； MIP

國際替代計量

磁共振三維短時間反轉恢復序列對臂神經叢之應用

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