磁振造影短時間反轉恢復序列技術於薦神經叢病變之運用－病例報告

The Application of MR 3D-STIR in Sacral Plexopathy-Case Report

林佳霓(Chia-Ni Lin) ； 陳文昌(Wen-Chang Chen) ； 陳志峰(Chih-Feng Chen) ； 王士崇(Shih-Chorng Wang) ； 林秋湧(Chiu-Yung Lin) ； 吳萬福(Wan-Fu Wu)

《中華放射線技術學雜誌》 39卷2期 (2015/06) Pp. 104-109

摘要

薦神經叢是由第四腰椎神經到第四條薦神經腹枝神經根所構成，薦神經叢五個主要分支為臀上神經、臀下神經、坐骨神經、後大腿皮神經和陰部神經，其中坐骨神經直徑最粗，且供應區域最大。薦神經叢病變主要可經由臨床症狀配合肌電圖、神經傳導檢查、X光檢驗、電腦斷層攝影、磁振造影等儀器來判斷病因。在骨盆腔常規磁振造影檢查之Axial、Sagittal、Coronal切面中，神經呈現片段狀，並無法輕易判斷出是否有神經病變，本研究病例乃利用3T磁振造影儀高解析度的特性，針對薦神經叢執行三維短時間反轉恢復序列磁振造影神經成像，讓神經呈現高訊號，再經由最大密度投影影像處理後，可以清楚的顯現出左側臀上神經萎縮、左側臀下神經萎縮、左側坐骨神經萎縮，確診為薦神經叢神經萎縮病變。經由本病例報告顯示短時間反轉恢復序列對於診斷腰薦神經叢病變影像品質良好，確實可以清楚的顯現出神經病變，降低誤診機會，進而提升影像診斷率，提高醫療品質。

關鍵字

薦神經叢病變 ； 短時間反轉恢復序列 ； 磁振造影神經成像

並列摘要

The sacral plexus((L4-5, S1-4) includes the superior gluteal nerves, inferior gluteal nerves, sciatic, posterior cutaneous nerve and pudendal nerve. Patients with perceived neurologic symptoms were referred for electromyography (EMG), nerve conduction studies, X ray, computed tomography, and magnetic resonance image. In routine pelvic magnetic resonance imaging, the neuropathy could not be determined easily from the axial, sagittal, and coronal sections data of the nerve segments. In this study, the authors analyzed the role of 3D-STIR images by which a normal nerve could be appeared slightly hyperintense as compared with the adjacent muscle tissue. Besides, the neuropathy associated with the left superior gluteal, the left gluteal nerve atrophy, and the left sciatic nerve atrophy could be clearly shown and diagnosed as sacral plexus nerve atrophy lesions through the maximal intensity projection image processing. We concluded that the 3D-STIR images provided additional diagnostic information.

並列關鍵字

Magnetic Resonance Neurography (MRN) ； Sacral plexopathy ； Short TI Inversion Recovery (STIR)