| 吕发金,谢鹏,牟君,朱丹,万东,李勇,李咏梅,肖智博.格林-巴利综合征腰丛神经磁共振成像研究[J].中国医学影像技术,2007,23(10):1457~1460 |
| 格林-巴利综合征腰丛神经磁共振成像研究 |
| Magnetic resonance neurography of lumbar plexus in patients with Guillain-Barre syndrome |
| 投稿时间：2007-04-10 修订日期：2007-07-21 |
| DOI： |
| 中文关键词: 格林-巴利综合征 磁共振神经成像 |
| 英文关键词:Guillain-Barre syndrome Magnetic resonance neurography |
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| 中文摘要: |
| 目的 探讨磁共振神经成像(MRN)对格林-巴利综合征(GBS)的诊断和鉴别诊断价值。方法 对临床诊断为GBS(21例)、慢性炎症性脱髓鞘性多发性神经病(CIDP, 4例)患者及正常人(30例)行腰丛神经MRN检查。正常组观测腰2~5神经根、神经节及神经干、股神经的形态、大小及信号;GBS及CIDP组观察神经及其周围的改变,测量右侧腰4神经根、神经节、神经干及股神经的短轴径线及神经肌肉信号比。结果 正常组MRN可清晰显示腰2~5神经的走行,神经节呈圆或椭圆形膨大,大小约为3~6 mm,神经根及干呈条状,边缘光滑,大小约为2~5 mm,神经节信号高于神经根和干,40%的神经根鞘有少量脑脊液,股神经、闭孔神经、腰骶干的显示率分别为100%、83.3%、43.3%。80.9%的GBS腰丛神经周围有片状模糊高信号,神经根和节大小和信号无明显改变,25%神经干增粗,50%的神经干信号增高,边缘模糊。CIDP神经周围无片状高信号,神经根及节无明显增大,神经干及股神经均明显增粗,信号增高。结论 MRN可清晰显示腰丛神经及主要大分支;GBS在神经周围有渗出病变,神经增粗不明显,CIDP神经周围无渗出病变,神经干明显增粗。MRN可作为GBS及CIDP诊断和鉴别诊断的重要手段。 |
| 英文摘要: |
| Objective To evaluate the diagnosis and differential diagnosis in patients with Guillain-Barre syndrome (GBS) using magnetic resonance neurography (MRN). Methods MRN was performed to evaluate the lumbar plexus, in 21 patients with clinically defined GBS and 4 with chronic inflammatory demyelinating polyneuropathy (CIDP), along with 30 healthy volunteers. The morphology, size and signal of nerve root, nerve ganglion, nerve trunk and femoral nerve, were observed. The brachyaxis and nerve-muscle signal ratio of right L4 nerve root, nerve ganglion and nerve trunk were measured. Results In healthy subjects, L2-L5 nerves were displayed clearly by MRN, with a round or ellipse ganglion of 3-6 mm in diameter, and smooth stick-like nerve root and trunk, 2-5 mm in diameter. The signal intensity was higher in ganglion than nerve root or trunk. 40% of nerve root sheath was surrounded by small amount of cerebrospinal fluid. Femoral nerve was displayed in all subjects, while only 83.3% of obturator nerve and 43.3% of lumbosacral trunk were manifested. Lamellar blurred hyper-signal intensity was seen around 80.9% of lumbar plexus in GBS, but none in CIDP. Thickening nerve trunk and increased nerve trunk signal intensity were more obvious in the CIDP, however no significant changes of nerve root and ganglion were observed in both. Conclusion The lumbar plexus and its major branches were visualized clearly by MRN. Exudation around the nerve was seen in GBS, while nerve thickening was more obvious with CIDP. MR neurography may be useful in the diagnosis and differential diagnosis of GBS. |
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