外周神经系统标准成像基础：磁共振神经影像学

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周围神经病是最常见的神经系统疾病之一。虽然已经有了完善的辅助仪器诊断方法，如神经肌电描记术和超声检查，但对各种原因引起的周围神经损坏，尤其是其近端损坏的诊断和鉴别诊断仍很困难。目前，外周神经的磁共振成像已被积极引入临床实践，成为一种宝贵的辅助诊断工具。

本文重点介绍上述检查方法的主要优点和局限性、使用磁共振成像来显示出周围神经系统结构的历史、考虑到现代技术能力的不同定位周围神经磁共振成像协议书的主要要求，包括对标准检查中使用的磁共振成像序列及其诊断价值、使用造影剂的建议以及各种脂肪抑制机制的优缺点的详细讨论。

目前，对正常和各种病变下的周围神经几乎没有标准化的描述，这降低该方法的诊断价值。为了提高该方法的信息量并扩大其应用范围，还需要对大量健康受试者和患有各种外周神经系统疾病的患者进行研究。

作者简介

Sofya N. Morozova

Research Center of Neurology

编辑信件的主要联系方式.
Email: kulikovasn@gmail.com
ORCID iD: 0000-0002-9093-344X
SPIN 代码: 2434-7827

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Viktoriya V. Sinkova

Research Center of Neurology

Email: 000564321@mail.ru
ORCID iD: 0000-0003-2285-2725
俄罗斯联邦, Moscow

Darya A. Grishina

Research Center of Neurology

Email: dgrishina82@gmail.com
ORCID iD: 0000-0002-7924-3405
SPIN 代码: 6577-1799

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Taisia A. Tumilovich

Research Center of Neurology

Email: tumilovich.taisiya@bk.ru
ORCID iD: 0000-0002-9538-9690
SPIN 代码: 2264-9457
俄罗斯联邦, Moscow

Andrey O. Chechetkin

Research Center of Neurology

Email: andreychechetkin@gmail.com
ORCID iD: 0000-0002-8726-8928
SPIN 代码: 9394-6995

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Marina V. Krotenkova

Research Center of Neurology

Email: krotenkova_mrt@mail.ru
ORCID iD: 0000-0003-3820-4554
SPIN 代码: 9663-8828

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Natalya A. Suponeva

Research Center of Neurology

Email: nasu2709@mail.ru
ORCID iD: 0000-0003-3956-6362
SPIN 代码: 3223-6006

MD, Dr. Sci. (Med.), Professor, Corresponding member of the Russian Academy of Sciences

俄罗斯联邦, Moscow

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2. 图1。臂丛磁共振成像（3D-T1模式，冠状面）：1——上干；2——中干；3——下干；4——神经周围脂肪组织；5——神经内膜脂肪；6——占位性肿块（神经鞘瘤）；7——肿块周围的完整脂肪组织。

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3. 图2。一名腕管综合征患者手部的T2模式磁共振成像，轴状面：a——掌骨近端骨骺水平；b——头状骨远端水平（1——正中神经内的独立神经束，2——神经外膜，3——增厚至1.29mm的屈肌支持带）。

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4. 图3。磁共振断层图像上不同的脂肪抑制方法：a——T2-FatSat模式下的臂丛，轴状面：脊神经C5、C6、C7的前支明显，无病变，信号略有升高，脂肪抑制不均匀，感兴趣区外围信号不理想（箭头）；b——STIR模式下的臂丛，冠状面：整个宽视野中脂肪抑制均匀，正常的臂丛神经有略有升高的信号（箭头）；c——T2-Dixon模式下的坐骨神经，冠状面：该技术提供均匀的脂肪抑制，正常的坐骨神经有略有升高的磁共振信号（箭头）。

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