臂丛神经的声像图特征及正常测值

目的 用超声观察正常人臂丛神经(BPN)锁骨上部的声像图特征及正常测值,了解左、右侧测值间有无差异,为临床诊治臂丛神经性疾病提供依据.方法 在44例无颈部及上肢疾患志愿者的颈部两侧设定斜线后放置探头.沿斜角肌之间做斜矢状切面扫查,观察BPN纵切面图像特征;再旋转探头,观察其横切面图像特征,并在前、中斜角肌间测量神经直径.结果 BPN纵切声像图特征为条状低回声,其强回声缘清晰;横切面呈圆形或类圆形的低回声,其强回声外缘不明显;用彩色多普勒显示血流,横切面位于锁骨下动脉后上方.测量结果,左、右侧上、中、下干分别为:(2.21±0.25)mm、(2.53±0.30)mm、(2.60±0.45)mm;(2.16±0.20)mm、(2.64±0.37)mm、(2.80±0.50)mm.经方差分析,两侧上、中干相比,中干均较粗;而中干与下干相比,差别无统计学意义.各干左、右侧对比,无明显差异.结论 臂丛神经在声像图上的特征性表现可为临床诊断神经性疾病提供形态学依据,用健侧测值作为对照,可作为判断正常与异常的一个指标.

Character and average diameter of brachial plexus nerves on ultrasonogram

Objective To observe the character and average diameter of brachial plexus nerves (BPN) on supraclavicular region in normal people using ultrasonography, to correlate the difference between right side and left side, and to offer index to diagnose and manage BPN diseases. Methods Forty-four volunteers, without any defect in cervical part or upper limbs, were studied, and the probe was put on supraclavicular region. First, observe the longitudinal section in obligue sagital plane from the interspace of scalene muscle, then observe the cross section, and measure the diameter of the BPN between the superior and middle part of scalene muscle. Results The character of BPN on longitudinal section on ultrasonography showed a strip of hypoechoeic area with a clear hyperechoeic background. The character of BPN on cross section showed a round or ovoid area, which was hypoechoeic with unclear hyperechoeic background. The position of the BPN on cross section was upper-posterior to the subclavian artery on Doppler study. The average diameters of the superior, middle and inferior trunks were: (2.21±0.25)mm, (2.53±0.30)mm, (2.60±0.45)mm on the left side, and (2.16±0.20)mm, (2.64±0.37) mm, (2.80±0.50)mm on the right side. By variance analysis, compared with superior trunk, the diameter of the middle trunk was more on both sides, while there is no statistical significant difference between the middle and inferior trunk. There is also no statistical significant difference between right and left sides. Conclusion The character of BPN on ultrasonography can offer a potential index in clinical use to diagnose and manage BPN diseases. Also, we can differentiate the normal from the abnormal nerve by comparing both sides.