Giá trị của cộng hưởng từ 3 Tesla trong chẩn đoán tổn thương đám rối thần kinh cánh tay ở trẻ em do chấn thương sản khoa

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Văn Giang Bùi, Văn Đoan Ngô, Hồng Hà Nguyễn, Kim Ngân Vương

Ngôn ngữ: vie

Ký hiệu phân loại: 571.47 *Effects of electricity and magnetism

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2022

Mô tả vật lý: 45300

Bộ sưu tập: Metadata

ID: 498666

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Đánh giá giá trị của cộng hưởng từ (CHT) 3Tesla (3T) trong chẩn đoán tổn thương đám rối thần kinh cánh tay (ĐRTKCT) sản khoa. Phương pháp nghiên cứu tiến cứu trên 47 bệnh nhân có triệu chứng lâm sàng và điện cơ của tổn thương đám rối thần kinh cánh tay sản khoa. Toàn bộ bệnh nhân được chụp CHT 3T ĐRTKCT trước phẫu thuật tại BV đa khoa quốc tế Vinmec (Hà Nội, Việt Nam) từ 09/2016 đến 03/2020 và điều trị phẫu thuật tại BV Việt Đức và BV Nhi trung ương (Hà Nội, Việt Nam). Các tổn thương trước hạch và sau hạch được mô tả và đối chiếu với kết quả phẫu thuật. Độ nhạy, độ đặc hiệu, độ chính xác, giá trị dự đoán dương tính và giá trị dự đoán âm tính đối với chẩn đoán tổn thương trước hạch lần lượt là 89,7%, 93,2%, 92,3%, 81,3% và 96,5%
đối với chẩn đoán tổn thương đứt rễ thần kinh sau hạch lần lượt là 78,7%, 89,8%, 84,7%, 86,7% và 83,2%
và đối với chẩn đoán neuroma rễ thần kinh lần lượt là 92,6%, 84,3%, 87,2%, 75,6% và 95,6%. CHT 3T là phương pháp chẩn đoán không xâm nhập, có giá trị cao trong chẩn đoán tổn thương ĐRTKCT sản khoa ở trẻ em đối với cả tổn thương trước và sau hạchThe objective of the study was to evaluate the diagnostic value of 3T MRI in diagnosing obstetric brachial plexus injury lesions in children. This was a prospective study, conducted on 47 patients who had clinical and electromyography manifestations of obstetric brachial plexus injury. All of the patients went through 3T MRI before surgery in Vinmec Hospital (Hanoi, Vietnam) from 09/2016 to 03/2020 and surgically treated (at Viet Duc and National Pediatric hospitals, Hanoi, Vietnam). The pre- and post-ganglionic injuries on MRI was correlated with intraoperative findings. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value for diagnosis of pre-nodal lesions were 89.7%, 93.2%, 92.3%, 81.3% and 96.5% respectively
diagnosis of postganglionic nerve root rupture were 78.7%, 89.8%, 84.7%, 86.7% and 83.2% respectively
diagnosis of nerve root neuroma were 92.6%, 84.3%, 87.2%, 75.6% and 95.6% respectively. We concluded that 3T MRI is a non-invasive diagnostic method, with high accuracy in diagnosing obstetric brachial plexus injury lesions in children, both for pre- and post-ganglionic injuries.

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