| Background With the increasing incidence of brachial plexus neuropathy,it is harmful to human physical and mental health.With the continuous development of nerve repair technology,how to accurately diagnose brachial plexus neuropathy and provide corresponding treatment is very important.As a kind of nerve combination with fusion and separation,the brachial plexus nerve has complex anatomy,superficial shape,more surrounding soft tissues,so it is very difficult to image.In addition,its pathological changes are diversified,and different pathological changes have different pathological changes and complications.As a non-invasive,multi parameter,multi-directional and high tissue resolution imaging technology,Magnetic resonance imaging(MRI)can not only observe the shape of nerve,but also reflect the signal changes of its internal and adjacent soft tissues,which has its unique advantages for brachial plexus imaging.Objective 3D Short Time Inversion Recovery Sampling Perfection with Application-optimized Contrasts by using different flip angle Evolution(3D STIR SPACE),as a relatively new MRI sequence,is applied to brachial plexus neuroimaging.However,the display of brachial plexus in the plain scan image is not clear and the background tissue inhibition effect is poor,which seriously affects the display of brachial plexus and the diagnosis of lesions,while the display effect of enhanced scan is significantly better.The purpose of this study is to explore the feasibility and clinical value of enhanced 3D short-time inversion recovery for rapid spin echo imaging in brachial plexus.Methods 33 cases of brachial plexus images were collected in our hospital,all ofthem were scanned by 3D STIRSPACE sequence with 3.0T high field strong magnetic resonance machine,and there was no contraindication of MRI scanning.Among them,10 volunteers underwent plain scanning,15 patients underwent plain scanning and enhanced scanning,and 8 patients only underwent enhanced scanning.After all the scans were finished,we performed the post-processing image of Multiplanar Imaging Technology(MIP),Multiplanar Imaging Technology(MPR)and Volume Reconstruction(VR),and then analyzed the original image and post-processing image.Two doctors above the deputy director of imaging diagnosis observed the imaging characteristics of brachial plexus,scored the effects of both plain and enhanced methods on brachial plexus display and peripheral tissue inhibition,and measured the contrast signal-to-noise ratio(CNR)of brachial plexus nerve and muscle.According to the characteristics of experimental data distribution,different data representation forms and statistical methods were used.The brachial plexus display score and background tissue inhibition score were tested by independent sample nonparametric test(Wilcoxon rank sum test);The contrast signal-to-noise ratio of 15 patients with plain and enhanced scanning was tested by self paired t-test.Result In The display score of brachial plexus was 2.04 ± 0.61 and background inhibition score was 1.6 ± 0.71 in 25 plain scanning images;the score of brachial plexus was 3.98 ± 0.51 and the background inhibition score was 3.57 ± 0.66 in 23 enhanced scanning images.There were statistically significant differences between the two groups(Z=5.895,P<0.01;Z=5.392,P<0.01).The CNR of 15 subjects receiving both plain and enhanced scanning were 0.37 ± 0.07 and 0.58 ± 0.08.There existed statistical differences(t=-9.412,P<0.01).Conclusion Compared with the plain scanning,3D STIR SPACE enhanced scanning can better display the shape and internal signal changes of brachial plexus,especially the display of the small nerve bundle at the distal end of the postganglion.It can reducethe interference of peripheral nerve tissues(blood vessels,fat,lymph,etc.)to brachial plexus,and has a higher contrast signal-to-noise ratio.Therefore,this imaging technology can obtain better quality of brachial plexus images,and can help clinicians to provide early and accurate diagnosis of lesions and corresponding treatment suggestions,and improve the prognosis of patients. |
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