BỘ GIÁO DỤC VÀ ĐÀO TẠO BỘ QUỐC PHÒNG
SCIENTIFIC RESEARCH INSTITUTE OF CLINICAL
MEDICINE 108
NGUYEN NGOC TRUNG
RESEARCH ON VISUAL CHARACTERISTICS AND
VALUE OF MRI IN THE DIAGNOSIS OF
TRAUMATIC BRACHIAL PLEXUS INJURY
Specialisation: Image Diagnostics
Code: 62.72.01.66
SUMMARY OF THE DISSERTATION OF MEDICINE
HA NOI - 2019
THE DISSERTATION WAS ACCOMPLISHER
SCIENTIFIC RESEARCH INSTITUTE OF CLINICAL MEDICINE 108
Supervisors:
1. Lam Khanh, Associate Professor, Doctor
2. Tran Van Riep, Associate Professor, Doctor
Reviewer 1:
Reviewe 2:
Reviewe 3:
The dissertation defence before the Institutional Board takes
place at....
Scienifically archived at:
1. National library
2. Scientific Research Institute of Clinical Medicine 108
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INTRODUCTION
Brachial plexus occurs when one or more nerve roots are removed
from the spinal cord at the base, or the nerves are stretched, cut, collapsed,
inserted. squeezing ... out of the hole. Brachial plexus injuries due to
traumatic injury tend to increase, mainly due to traffic accidents.
Worldwide studies such as Oliveira CM (2015), Jain DK (2012) all
confirmed the main cause of traffic accidents (78.7 and 94%). In Vietnam,
according to NC of Ho Huu Luong (1992), the incidence of neck spine
injuries was high (60-70%). According to Le Van Doan (2013), Brachial
plexus injuries due to traumatic injuries are not rare and the main cause
is traffic accidents.
In the world and in Vietnam, there have been some researches of
MRI of brachial plexus injuries due to traumatic injury. However, these
studies do not have a multifaceted assessment of injury due to disease
limitation. Based on the above situation, we conducted a study entitled
"Research on visual characteristics and value of MRI in the diagnostic of
traumatic brachial plexus injury" with two objectives:
1. Characterization of imaging of brachial plexus injuries due to
traumatic injury on 3 Tesla MRI.
2. Determine the value of the 3 Tesla MRI in Diagnosis of brachial
plexus injuries versus surgery.
Dessertation novelty: The study is the first one in Vietnam to
apply 3 Telsa MRI in the evaluation of traumatic brachial plexus injury.
Contribution to Image Diagnostics: A new diagnostic technique
is developed.
Contribution to Treatment: The study assesses systematic
brachial plexus injury and simultaneously indicates the correlation
between clinic and image diagnostics, thus assisting clinical practitioners
in the determination of an appropriate treatment policy to recover
effectively the patients’ functions.
Thesis structure
The dissertation consists of 124 pages: Question 2 pages, overview
36 pages; Subject and methodology 15 pages; Results 31 pages;
Comment 37 pages; Conclusion 2 pages; Recommendation: 1 page. The
thesis consists of 41 tables, 45 figures, 7 graphs, 119 references
(Vietnamese: 18; 101)
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Chapter 1
OVERVIEW DOCUMENT
1.1. The role of MRI in the diagnosis of brachial plexus injuries
MRI is a visualization method based on the principle of putting
the body into a strong magnetic field to synchronize the direction of
motion of the hydrogen atoms in the water molecules and then use a radio
frequency antenna Low to activate the tissues in the body, hydrogen
atoms will resonate and emit signals. In the magnetically stable magnetic
field, the radio frequency will vary according to the purpose of the survey,
the target group of the various organs (parenchyma, muscle, fat, water,
blood vessels, etc.). The emitted signal is picked up by the antenna and
transmitted to the signal processing computer and the control computer,
whereby the image of the body structure is displayed.
With the new high-powered MRI camera, the Gyroscan Achieva 3 Tesla
from Phillips (The Netherlands), uses T2W of Vista Sense with the help
of 3D rendering and rendering software, the root, stem, bundle, and part
of the branches are separated, while separating the rotifer with other
complex structures in the neck.
1.2. Situation of MRI in diagnosis of traumatic brachial plexus injury
Early in the world, there were some researches related MRI
traumatic brachial plexus injury, namely Blair DN et al (1987), Bilbey JH
et al (1994). Authors Cejas DC (2015) and Fan YL (2016) conclude that
MRI is a useful supplement to clinical diagnosis, helping to select the best
course of treatment for patients.
In Vietnam, as we know, only a few published results of the
group of authors of 108 Military Central Hospital, namely Dinh Hoang
Long (2012) concluded that MRI and surgical outcome were highly
relevant (80.6%) after comparisons.
Chapter 2
OBJECTIVES AND RESEARCH METHODS
2.1. Research subjects and methods
The study was conducted on 60 patients who were examined
and treated at the 108 Military Central Hospital from January 2012 to
December 2014.
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2.1.1. Standard selection
- Patients with a history of trauma, traumatic events with paralysis or
paralysis and clinical examination and determination of lesions and
symptoms of MRI Tesla 3.
- Being treated for traumatic brachial plexus injury at the Military
Orthopedic Trauma Institute, 108 Military Central Hospital and a surgery
document describing the lesions of traumatic brachial plexus injury
according to the medical records of this study.
2.1.2. Exclusion criteria
Patients who is suffering from traumatic brain injury, but not
due to traumatic injury, but due to medical disease, multiple injuries.
Patients who do not agree to participate in this study. Patients who are not
recorded in the medical records.
2.1.3. Sample size
Instead of the formula we have n = 48 patients.
2.2. Research Methods
A prospective, cross-sectional descriptive study comparing the
diagnosis of brachial plexus injuries on MRI 3 Tesla befor surgery with
postoperative diagnosis.
2.2.2. Research content
2.2.2.1. General characteristics of brachial plexus injuries: Age,
gender, causes of injury, combined injury, place of injury, time from
illness to imaging, duration from illness to surgery.
2.2.2.2. Image of brachial plexus injuries on MRI
In combination with the diagnostic criteria of some authors, we
propose to investigate 10 signs of brachial plexus injuries on MRI 3 Tesla
as follows: spinal cord stenosis, oedema from preganglionic, root
avulsion, pseudomeningocele, diarrhea (root, trunk, cords), swelling
(root, trunk, cords), Rupture in the sheath (root, trunk, cords),
Incomplete rupture, rupture (root, trunk, cords), atrophy
- The above-mentioned brachial plexus injuries are described
in the following positions: divided by anatomy and T1W vertical, T2W
longitudinal, T2W horizontal, T2-weighted, T2-weighted, T2-weighted,
myelography ), MIP and 3D
- Location of marrow and root, trunk, cords on all MRI
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