磁共振扩散张量成像在椎间盘损伤中的临床应用价值  

Clinical Application of MR DTI in Acute Contusion of Lumbar Disc

作　　者：杨蔚[1] 金国宏[1] 郭玉林[1] 朱凯[1] 赵建国[1] 张伟[1] 李宁富[1] 高知玲[1] 李德刚[1] 

机构地区：[1]宁夏医科大学附属医院放射科,银川750004

出　　处：《临床放射学杂志》2011年第4期556-560,共5页Journal of Clinical Radiology

摘　　要：目的应用磁共振扩散张量成像(DTI)及示踪纤维(FT)技术观察椎间盘纤维环的形态和完整性,评价其在椎间盘急性损伤中的应用价值。资料与方法分别对9名正常志愿组者、14例椎间盘外伤患者的脊椎行GE1.5TSigna MR扫描,所有外伤患者均在伤后1周内进行。行常规MR矢状位T1WI、T2WI及轴位T2WI、DTI扫描。将数据输入GE ADW 4.4工作站,应用Functool后处理软件生成各向异性分数(FA)图、平均扩散系数(ADC)图和FT图。观察纤维环的形态和完整性,测量正常纤维环和损伤断裂处及损伤周围纤维环的FA值和ADC值。结果所有受检者均获得清晰的FA图、ADC图及椎间盘纤维环FT图。正常组纤维环在FA图和ADC图上呈一连续完整的环形结构,FA值和ADC值均匀,FT图显示纤维环形态完整。椎间盘损伤者纤维环呈不同程度的断裂,纤维板结构紊乱,髓核不同程度偏移及碎裂,断裂处纤维环的ADC值升高,FA值降低。断裂周围纤维环的ADC值降低,FA值升高。组间比较差异有统计学意义。结论 DTI-FT技术能够在活体组织中无创显示椎间盘纤维环的形态和完整性,发现急性外伤后纤维环是否损伤、断裂,断裂的位置和断裂的程度,是常规MRI检查的重要补充。Objective To study the clinical application of MR DTI in acute contusion of lumbar disc.Materials and Methods 23 subjects including normal volunteer（n=9）and lumbar disc injury（n=14）were examined with 1.5T signal MR in a week after acute contusion.MR sequence contained conventional sagittal T1,T2WI,axial T2WI and axial DTI.The DTI source images were transfered to the ADW 4.4work station and FT picture,FA picture and ADC picture were analyzed.Results With the average ADC value and FA value uniform,the normal disc annulus fibrosus was appeared as a continuous and integrated circulus in FA picture and ADC picture,at the same time annulus fibrosus on FT picture was continuous and complete.There were 14 Patients with different degrees of tissue injury in acute contusion,annulus fibrosus was disrupted on FT picture,the ADC value increased and FA value decreased in disrupted place,while the ADC value decreased and FA value increased in the areas away from disrupted place.Compared with normal volunteer,there were statistically significant differences of FA and ADC values among them.Conclusion DTI can noninvasively display morphous and integrity of the lumbar disc anulus fibrous,it is an important supplement to conventional MRI.

关 键 词：椎间盘 磁共振成像 扩散张量成像 急性损伤 影像诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]