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目的探讨高频超声在诊断臂丛神经闭合性损伤和肿瘤中的价值。方法用高频超声检查和诊断6例创伤性臂丛神经损伤与3例臂丛神经肿瘤,随机选择12例健康成年人作为正常对照组,观察臂丛神经的正常超声图像。结果高频超声显示斜角肌间隙和锁骨下动脉是臂丛神经检查的重要解剖标志,正常臂丛神经长轴显示多条线性平行回声,短轴呈圆形中等回声,内有点状弱回声,C_(5～7)和上、中干显示率为100%(12/12),C_8、T_1和下干显示率为83.3%(10/12)。6例臂丛神经损伤显示神经增粗水肿,部分正常束状回声消失或不连续,内部点线回声不清,呈略低回声与周围软组织粘连。3例臂丛神经肿瘤显示为实性瘤样低回声与臂丛神经相连续,其内有血流信号,其中2例为超声检查最早诊断。结论高频超声可作为检查臂丛神经闭合性损伤和肿瘤的首选方法,值得临床推广应用。
Objective To investigate the value of high frequency ultrasound in the diagnosis of brachial plexus injury and tumor. Methods Six cases of traumatic brachial plexus injury and three cases of brachial plexus tumor were examined and diagnosed by high frequency ultrasound. Twelve healthy adults were randomly selected as normal control group to observe the normal ultrasound image of brachial plexus. Results High-frequency ultrasound showed that the mesangial interlobular space and the subclavian artery were important anatomical landmarks for brachial plexus examination. The long axis of the normal brachial plexus showed a number of linear parallel echoes, the short axis was a circular middle echo, The rates of C_ (5 ~ 7) and upper and middle stems were 100% (12/12), while those of C_8, T_1 and lower stems were 83.3% (10/12). 6 cases of brachial plexus injury showed nerve thickening and edema, part of the normal beam echo disappeared or discontinuous, the internal point line echo is not clear, was slightly hypoechoic and surrounding soft tissue adhesions. 3 cases of brachial plexus tumors showed solid tumor-like hypoechoic and brachial plexus continuous, which has blood flow signals, including 2 cases of earliest diagnosis of ultrasound. Conclusion High-frequency ultrasound can be used as the first choice for examining brachial plexus injury and tumor, which is worthy of clinical application.