磁共振扩散张量成像定量评估腰骶神经根压迫症  

Diffusion tensor imaging with quantitative evaluation in lumbosacral radiculopathy

作　　者：秦朗 时寅 刘继永 刘波[1] 张永杰[2] Qin Lang;Shi Yin;Liu Jiyong;Liu Bo;Zhang Yongjie(Department of Radiology,the First Affiliated Hospital of NMU,Nanjing 210029;Department of Humari Anatomy,NMU,Nanjing 211166,China;Department of Teaching Affairs,NMU,Nanjing 211166,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]南京医科大学人体解剖学系,江苏南京211166 [3]南京医科大学教务处,江苏南京211166

出　　处：《南京医科大学学报（自然科学版）》2018年第12期1715-1719,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81472081);国家自然科学青年基金(81100942);江苏省自然科学基金(BK2010539)

摘　　要：目的:采用磁共振扩散张量成像(diffusion tensor imaging,DTI)技术,定量测量腰椎间盘相关腰骶丛神经根压迫症患者神经根各项异性分数(fractional anisotropy,FA)值,评估腰骶丛神经根DTI运用于腰椎间盘相关腰骶神经根压迫症术前诊断与预后评价的潜在价值。方法:对34例单侧腰骶丛神经根压迫症患者行腰骶神经根DTI检查,并行扩散张量示踪成像(diffusion tensor tractography,DTT),定量腰骶丛神经根3个层面神经根FA值,均使用日本骨科协会下腰痛评估治疗分数(Japanese Orthopedic Associationfor the Assessment of Treatment for Low Back Pain,JOA)进行临床功能症状评分,并进行相关性分析研究。结果:扩散张量示踪成像DTT显像所示,神经根神经纤维束异常均与临床症状相符,患侧神经根远中近段神经根FA值不相等,神经根FA值由近端至远端递减,患侧远中近段神经根FA值均低于健侧,病变责任神经根FA值与术前临床JOA评分值有较高的相关性。结论:腰骶丛神经根DTI成像可定性评价腰椎间盘相关腰骶神经根压迫症中责任神经根的损伤变性,并能通过神经根FA值,定量反映责任损伤神经根变性所致相应神经支配区域感觉异常及运动功能障碍。对于腰椎间盘相关腰骶神经根压迫症的术前诊断及预后评价具有较重要的临床应用价值。Objective:To quantitatively evaluate nerve roots by measuring fractional anisotropy(FA)values in lumbar intervertebral disc related compression of lumbosacral plexus nerve roots by MR diffusion tensor imaging(DTI). To evaluate the potential value of DTI in preoperative diagnosis and prognosis evaluation of disc related lumbosacral nerve roots compression. Methods:Thirty-four unilateral disc related lumbosacral nerve roots compression patients underwent MR imaging using diffusion tensor tractography(DTT).FA values for nerve roots were calculated at three levels from DTI images. Japanese Orthopedic Associationfor the Assessment of Treatment for Low Back Pain(JOA)score and correlation analysis were performed on the clinical function of the patients. Results:The abnormalities of symptomatic nerve tracts were distinctly showed by tractography. On the symptomatic side of nerve roots,the mean FA values displayed a significant declining tendency from proximal to distal. The FA values of the symptomatic side of the nerve roots were significantly lower than those of the asymptomatic side at the proximal,medial and distal levels. The mean FA value of nerve roots correlated moderately with the JOA score. Conclusion:DTI imaging of the lumbosacral plexus nerve roots in lumbosacral nerve roots compression is related to the preoperative evaluation of responsible nerve roots compression of lumbar disc nerve roots. The diversities of nerve roots quantitative FA values reflect the degenerated nerve roots caused by the abnormal sensation and motion dysfunction.

关 键 词：扩散张量成像 神经根病 脊神经根 

分 类 号：R445.2[医药卫生—影像医学与核医学]