再生周围神经界面的磁共振成像外观

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2024-09-10 DOI:10.1016/j.bjps.2024.09.017

Yoav Morag , Theodore A. Kung , Samer Soussahn , Qiaochu Chen , Paul S. Cederna

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引用次数: 0

摘要

目的描述再生周围神经界面（RPNI）的核磁共振成像外观以及核磁共振成像外观与 RPNI 修复之间的潜在关联。材料和方法对 2010 年 1 月 1 日至 2023 年 7 月 29 日期间在我院进行的 RPNI 的核磁共振成像外观及临床相关性进行回顾性评估。结果14名患者（8男6女，年龄范围31-80岁，中位年龄51岁）的RPNIs核磁共振成像技术合格，其中包括5名膝下截肢患者的5条胫神经和4条腓总神经RPNI，8名膝上截肢（AKA）患者的坐骨神经RPNI，以及1名前肢截肢患者的臂丛神经RPNI。两名患者接受了三次 RPNI 翻修手术（AKA-坐骨神经），共进行了 6 次 RPNI 翻修。在T1加权序列上，所有RPNI与肌肉呈等密度，并与周围的疤痕和肌肉组织相融合，而在T2加权序列上，与肌肉相比，所有RPNI的信号均呈高密度。除 1 例 RPNI 外，其他所有 RPNI 都出现了不同模式的对比后增强。结论 MRI 上的 RPNI 在 T2 和 T1 加权序列上分别呈明亮和中间信号，通常会出现不同模式的对比后增强，但在进行和未进行后续 RPNI 修复手术的病例之间没有明显的统计学差异。不过，不应将 RPNI 的增强误解为病理增强。

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Magnetic Resonance Imaging appearance of regenerative peripheral nerve interface

Purpose

To describe the MRI appearance of regenerative peripheral nerve interface (RPNI) and the potential association between the MRI appearance and RPNI revision.

Material and methods

A retrospective assessment was undertaken of the MRI appearance of RPNIs performed at our institution between 1/1/2010 and 7/29/2023 with clinical correlation.

Results

Fourteen patients (8 men and 6 women, age range 31–80 years, median age 51 years) with technically adequate MRI of RPNIs were included in this study including 5 patients with below knee amputation with 5 tibial and 4 common peroneal nerves RPNI, 8 patients with above knee amputations (AKA) with sciatic RPNIs, and 1 patient following forequarter amputation with a brachial plexus RPNI. Two patients underwent revision RPNI surgery thrice (AKA-sciatic nerve) for a total of 6 RPNI revisions. On T1 weighted sequences, all RPNIs were isointense to the muscle and blended with the surrounding scar and muscle tissues whereas on T2 weighted sequences, all RPNIs were hyperintense in signal compared to the muscle. All but 1 RPNI underwent post contrast enhancement in variable patterns. No statistically significant difference in MRI appearance was found between RPNIs with or without a following RPNI revision surgery.

Conclusion

RPNI on MRI typically have a bright and intermediate signal on T2 and T1 weighted sequences, respectively, and typically undergo postcontrast enhancement in variable patterns without a statistically significant difference between the cases with and without follow-up RPNI revision. However, enhancement of RPNI should not be misconstrued as pathological.

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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.