BƯỚC ĐẦU NGHIÊN CỨU ĐẶC ĐIỂM GIẢI PHẪU SIÊU ÂM ĐÁM RỐI THẦN KINH CÁNH TAY VÙNG CỔ

Abstract

SUMMARY

Objective: To describe the sonographic appearance of the normal brachial plexus and to suggest the suitable region for brachial plexus blockade under the guidance of ultrasound.
Subjects and methods: 15 patients whose age varies from 32 to 83, hospitalized at ultrasonography department in Hue Central Hospital from 3/2012 to 4/2012. The subjects had beenultrasound scanned to locate the brachial plexuses. Their sonographic appearances and relationship with surrounding structures then were described and cross- sectional description were studied.
Results: Of all 15 subjects, brachial plexus appearances were well vizualized at interscalene and supraclavicular region. At infraclavicular region however, the same result occured in only 3 subjects, equaling to 20%. The brachial plexus was visualized as a
chain of hypoechoic nodules representing the trunks at interscalene
region, a cluster of hypoechoic nodules representing the divisions
at the supraclavicular and hyperechoic nodules representing the cords of which diameters decrease from roots to nervous fiber. Brachial plexus’s location is nearer from skin at its roots and deeper
towards the fiber end. Antomically, brachial plexus relates to stenocleidomastoid muscle, anterior scalene muscle, interscalene,
subclavian artery at superior thoracic aperture and lung membrane
at subclavian region. The brachial plexus that locates at interscalene
region is the most suitable for brachial plexus desensitilization with
ultrasound guide method for better efficiency and safety.
Conclusion: Initial studies of anatomical ultrasound imaging of the brachial plexus in the neck region result in two conclusions. Firstly, high resolution ultrasound (7-10 MHz probe) allows clear description of brachial plexus from roots to divisions, and clear description of cords in about 20% of cases. Lastly, the interscalene region is the best place for neck region brachial plexus desensitilization with ultrasound guide method for its highest possibility of success and least complication.