ĐÁNH GIÁ HIỆU QUẢ KỸ THUẬT CHỤP CỘNG HƯỞNG TỪ 3.0 TESLA BỘC LỘ TỔN THƯƠNG ĐÁM RỐI THẦN KINH CÁNH TAY SAU HẠCH DO CHẤN THƯƠNG TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objective: To evaluate the effectiveness of 3.0 Tesla MRI in detecting and assessing post-ganglionic brachial plexus injuries caused by trauma, aiming to assist accurate diagnosis and appropriate treatment planning. Subjects and Methods: A cross-sectional descriptive study involving 50 patients with traumatic injuries to the neck, shoulder, and upper limb, confirmed through clinical examination and electromyography, followed by MRI of the brachial plexus at 3.0 Tesla using a specialized protocol including T1W, T2W Sagittal, 3D Axial T2 HSCUBE, and 3D STIR Coronal sequences. Image characteristics, sequence effectiveness, and diagnostic value were analyzed and compared with surgical findings using SPSS software. Results: Among the 50 patients, predominantly male (male/female ratio of 9.6), with an average age of 33, mostly caused by traffic accidents (48%). Commonly affected roots were C5, C6, and C7, with complete nerve root ruptures accounting for 36.9%, and edema 13.91%. The 3D STIR Coronal sequence had the highest sensitivity (91.3%) and a specificity of 70.37% in detecting nerve ruptures. When compared to surgical results, the MRI's sensitivity for detecting ruptured roots was 75.9%, specificity 85.03%, and overall accuracy 82%. Conclusion: 3.0 Tesla MRI plays a vital role in accurately locating, visualizing, and assessing the severity of post-ganglionic brachial plexus injuries, aiding in treatment and surgical decision-making. Among the sequences, 3D STIR Coronal offers the highest sensitivity and specificity, making it a valuable diagnostic tool for post-traumatic nerve injuries.