中文摘要：

目的评价MRI诊断臂丛神经损伤的临床价值。方法98例临床诊断臂丛神经损伤的患者在手术前行MR检查，其中54例采用Philip Gyroscan T5-Ⅱ型0．5T超导MR仪，44例采用Philip Intera 1．5T超导MR仪。采用头颈联合线圈或颈部阵列线圈，行横断和冠状面扫描。扫描序列为SE T1WI、T2WI和快速梯度回波（FFE）序列T2WI、T2WI反转恢复（SPIR）压脂序列。98例中63例行锁骨上手术探查，将术中发现与MRI结果比较；35例未手术的患者经临床随访证实。结果MRI显示椎管内损伤45例，椎管外损伤56例，其中椎管内外混合性损伤16例，未发现损伤征象13例，阳性率86．73％。节前损伤的征象包括：（1）脊髓水肿和出血2例（4．44％）；（2）脊髓移位17例（37．78％）；（3）创伤性脊膜囊肿37例（82．22％）；（4）神经根缺失25例（55．56％）；（5）椎管内瘢痕24例（53．33％）；（6）失神经肌肉萎缩和脂肪浸润13例（28．89％）。节后损伤的征象包括：（1）神经干增粗、信号增高23例（41．07％）；（2）神经干连续性中断，结构消失16例（28．57％）；（3）神经干连续性存在，但结构紊乱14例（25．00％）；（4）创伤性神经纤维瘤形成3例（5．36％）。结论MRI能够同时显示臂丛节前和节后神经损伤，对鉴别节前损伤、节后损伤、损伤类型，以及确定治疗方案和选择治疗时机均具有重要的临床应用价值。

英文摘要：

Objective To evaluate the diagnostic value of MRI in brachial plexus injury. Methods Total 98 patients with brachial plexus injury were examined by MRI before operation. Fifty-four of 98 patients MR imaging were obtained by 0. 5 Tosla scanner and other 44 patients were obtained by 1.5 Tesla scanner. The scanning sequences include： SE T1WI, T2WI, FFE T2WI and T2WI SPIR Exploration of the supraclavicular plexus was carried out and the MR imaging were compared with the operative finding in 63 patients. Thirty-five patients who had not surgery were followed-up. Results MR imaging found pre-ganglionic injuries in 45 patients and post-ganglionic injuries in 56 patients. Pre- and print- ganglionic injuries simultaneously in 16 patients among them. MR imaging can not find injury sings in 13 patients. The positive rate was 86. 73%. MR imaging finding of pre-ganglionic injuries include： （1） Spinal cord edema and hemorrhage, 2 patients （4. 44% ）. （2） Displacement of spinal cord, 17 patients （37.78%）. （3） Traumatic meningoceles, 37 patients（82. 22% ）. （4） Absence of roots in spinal canal, 25 patients（55.56% ）. （5）Searring in the spinal cnanl,24 patients（53.33% ）. （6） Denervation of erector spine, 13 patients （28. 89%）. MR imaging finding of post-anglionic injuries include： （1） Trunk thickening with hypointensities in T2WI, 23 patients （41.07%）. （2） Nerve trunk complete loss of continuity with disappeared of nerve structure, 16 patients （28. 57% ）. （3） Continuity of nerve trunk was well with disappearance of nerve structure, 14 patients （25.00%）. （4） Traumatic neurofibroma, 3 patients （5.36%）. Conclusion MR imaging can reveal Pre- and post- ganglionic injuries of brachial plexus simultaneously. MR imaging is able to determine the location （pre- or post- ganglionic ） and extent of braehial plexus injury, provided important information for treatment method selection.