腰椎间盘突出症的神经根三维磁共振选择性水激励脂肪抑制技术成像特征分析  

Three-dimensional MR-PROSET Imaging of Spinal Nerve Root in Lumbar Disc Herniation

作　　者：李丽艳[1] 周顺科[2] 郭云志[1] 郭薇[1] 高阳[1] 

机构地区：[1]吉林省吉林市人民医院放射科,132001 [2]中南大学湘雅二医院放射科

出　　处：《中国全科医学》2013年第24期2848-2851,共4页Chinese General Practice

摘　　要：目的探讨磁共振(MR)选择性水激励脂肪抑制技术(PROSET)对腰椎间盘突出症(LDH)患者神经根的显示作用。方法选取2012年3—9月在本院行脊神经根MR PROSET成像者47例,其中正常者20例,LDH患者27例,分析所有受检者MR常规扫描和PROSET冠状位腰神经根成像,并经最大信号强度投影(MIP)、容积再现(VR)三维重组处理,观察脊神经根形态、走行及其与椎间盘突出髓核的关系。结果 20例正常者MR PROSET成像均清楚显示硬膜囊、硬脊膜鞘外形及脊神经根节前段、神经节和节后段的走行。27例LDH患者中,共计30个椎间盘突出,其中中央型16个,侧旁型11个,椎间孔型3个。各型LDH神经根三维PROSET成像特征表现为:椎间孔型突出的髓核向外上推压同侧上位神经根,向内侧推压下位神经根;侧旁型仅推压下位神经根;中央型多数无神经根受压征象。结论 MR PROSET成像能清晰显示各型LDH患者椎间盘突出的髓核对神经根压迫的特征,尤其对椎间孔型更有优势,故MR PROSET可以为LDH患者神经根受压情况的诊断提供依据。Objective To investigate the clinical value of magnetic resonance （MR） principle of selective excitation technique （PROSET） in showing spinal nerve roots and diagnosing lumbar disc herniation （LDH） . Methods 47 patients （20 healthy people and 27 LDH patients） underwent MR and PROSET from March to September in 2012 were selected. Each case was performed maximum intensity projection （MIP） and volume rendering （VR） three - dimensional reconstruction. The shape of spinal nerve roots and its relationship with herniated disc were observed. Results The dura, dura sheath, spinal nerve root, ganglias, segments of the nerves posterior to the ganglions could be shown well with MR PROSET and could be observed from multiple aspects by MIP and VR. Among the 27 LDH patients, there were totally 30 herniated discs, including 16 central types, 11 lateral side types and 3 intraforaminal types. The features of PROSET of each type of LDH were ： the intraforaminal type showed that the nucleus pulposus pushed outward the ipsilateral epistatie nerve root and push inward inferiority nerve root, while nucleus pulposus only pushed inferiority root in lateral side type of LDH and there were no nerve root compression in most of the central types. Conclusion The morphology of the lumbar nerve root and its surrounding structures as well as the nerve root compression can be non - invasively and accurately detected by PROSET images. MR PROSET is a very useful method in the diagnosis of the symptomatic LDH.

关 键 词：椎间盘移位 腰椎 脊神经根 磁共振成像 选择性水激励脂肪抑制技术 

分 类 号：R681.533.1[医药卫生—骨科学]