High-resolution Ultrasonographic Features and Localzation of Normal Adult Brachial Plexus Nerve Roots and Intervertebral Foramen
|School||Fourth Military Medical University|
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||Brachial Plexus Intervertebral Foramen High-resolution Ultrasonography|
Background: The anatomical structure of human’s anterior cervical reoperations area is very complicated. as far as cervical radicular spondylosis、Vertebral arterial cervical spondylosis and Brachial plexus injury be concerned Accurate positioning which part of the intervertebral foramen and nerve root is injuryj is very important to clinical care and therapeutic outcome.The characteristics of those disease is the level of injury areas is high , involving more than one vertebral segment, nerve regeneration slower.With the constant improvement of diagnostic technique,it request to make non-invasive diagnosis become necessary.Consequently, has a better understanding for neck nerve root and its surrounding bone structure and produce a set data of against brachial plexus intervertebral foramen and nerve root of ultrasound measurement become the present problems needed to resolve.This study adopts anatomy, imaging of combining multidisciplinary and interdisciplinary crossover study method, start with the anatomical structure of Intervertebral foramen, brachial plexu. Explore both the localization and of measurement intervertebral foramen under ultrasonic and the brachial plexus of ultrasonographic feature .In order to achieve the cervical intervertebral foramen、brachial plexus anatomical data and image information. It also has important significance for diagnosis and treatment and provide new imaging method and Originality data.Objective: This study observe adult brachial plexus root and corresponding intervertebral foramen of morphological traits observation and measurement through the application of high-frequency color doppler ultrasonography, to explore the high-frequency ultrasound to normal adult brachial plexus root morphology and the intervertebral foramen and positioning accuracy and influencing factors. Found the method of examination and image standardization and establishing normal adult brachial plexus and corresponding intervertebral foramen ultrasonic references. Those imaging basis can be used as a judge normal and abnormal index for early diagnosis of cervicalspondy-lotic radiculopathy and brachial plexus injury, improve the accuracy of local anesthesia successful rate .Methods:1. Choose defrost adult corpses neck thoracic segments,Using high-frequency ultrasound observe the anatomical structure of brachial plexus. In a display nerve root long axis using ultrasound-guided puncture to position and mark the location of intervertebral foramen、top of transverse process、root of transverse process for the C5 ~ T1 vertebral body, than dissection the marked body, compare probe position and ultrasound image .2. Choose the anticorrosive fixed adult corpses neck thoracic segments specimens. Layered divest soft tissue, Observation and record:①Brachial plexus surface projection、origination and the anatomic structure of C5～T1 foramen intervertebrale ;②Structure of foramen intervertebrale and the relationship of brachial plexus nerve root with the surrounding tissue when it cross intervertebral foramen;③Use vernier caliper to measure diameter and length of the C5～T1 foramen intervertebrale and nerve root.3. Use high frequency ultrasound to observation brachial plexus of normal healthy adultand record:①Brachial plexus surface projection、origination and the Anatomic structure of C5～T1 foramen intervertebrale;②Structure of foramen intervertebrale and the relationship of brachial plexus nerve root with the surrounding tissue when it cross intervertebral foramen;③Use vernier caliper to measure diameter and length of the C5～T1 foramen intervertebrale and nerve root.Results:1. Results of high-frequency ultrasound audio-visual figure shows the intervertebral foramen and position in the dissection results are consistent . The image of cervical vertebral horizontal turkestan root and vertebral artery sonographic findings is the important anatomical marks to identify and location Intervertebral foramen inside nerve root issued its level.2. Brachial plexus cross-section after subclavian artery, we can see the darker hypoechoic class round and pass through the The anterior scalene and middle scalene rooms;Vertical scanning the neck sagittal section inclined,shows that the nerve root is the darker, hypoechoic linear pass between the same section horizontal axon since before and after the Transverse process. The never is structure bordered by a thin hyperechoic rim. All of the C5～C8 never root can be observing in 50 cases,the display rate is 100%; The display rate of T1 is only 14%.3. Comparing the both side diameter of C5 ~ C8 nerve root and the intervertebral foramen of cadaver carotid thoracic segments specimens and the normal adult by using Student’s t-test, P > 0.05, the difference was statistically significant, cervical intervertebral foramen and nerve root in high frequency ultrasound measurements and specimens under between measurement value no significant difference (P > 0.05). T1 nerve root located between first and second rib collarbone, because of shelter from collarbone and lung , the T1 nerve root is not clear to show, sample is not enough to analysis.Conclusions:1. The study demonstrates that use high-frequency ultrasound can not only be accurate and dynamically display of the relationship of normal brachial plexus root and tract and the surrounding tissue anatomic,but also can accurately describe brachial plexus nerve root inside the intervertebral foramen and the morphological characteristics of nerve root long axis views was clearly observed, positioning of their corresponding intervertebral foramen location.2. This study summarized the characteristics of ultrasonographic in normal brachial plexus nerve roots and its intervertebral foramen . Expanded the ultrasound application scope,as for neck intervertebral foramen and its adjacent nerve root lesions caused by many in the early diagnosis of this disease to open new window. 3. The obtained corresponding brachial plexus and the intervertebral foramen and ultrasound measurement values, which related as brachial plexus injury and disease nerve normal abnormal dudgment index and makes up the deficiency of other examine. It also has important significance for diagnosis and treatment and provide new imaging method and Originality data.