核磁共振扩散张量成像辅助评估腰肌扭伤  

MR-DTI auxiliarily assessing lumbar muscular strain

作　　者：欧阳林[1] 汤奕林 肖玉辉[1] 罗爱芳[1] 

机构地区：[1]解放军第175医院(厦门大学附属东南医院)医学影像科,福建漳州363000

出　　处：《中国骨与关节损伤杂志》2014年第10期1018-1020,共3页Chinese Journal of Bone and Joint Injury

基　　金：漳州市科技计划课题(Z07019)

摘　　要：目的应用核磁共振扩散张量成像(MR-DTI)辅助常规MRI诊断腰肌扭伤。方法应用3.0 T MR对13例腰肌扭伤成像:常规序列tse-T1WI,tse-T2WI-FS,tse-T1WI-CE和辅助诊断序列DTI。基于DTI完成组织结构解剖和分数各向异性的融合图(Anat-FA),肌纤维束追踪图(MFT)。对照评价T1WI、T2WI、T1WI-CE、Anat-FA图在显示损伤程度、范围方面的差异,应用MFT图显示肌纤维结构破坏情况。结果腰肌损伤的严重性与组织弥散张量的分数各向异性(FA)下降、表观弥散系数(ADC)和张量轨迹加权值(TraceW)上升以及T2WI、T1WI-CE信号增加相关。T2WI图与T1WI-CE图显示的损伤区面积差异无统计学意义(P=0.42),Anat-FA图显示的损伤面积大于T2WI图(P<0.001)和T1WI-CE图(P=0.01)所显示的损伤面积。MFT图显示的肌纤维断裂程度与T2WI和T1WI-CE显示的损伤程度一致。结论与常规MRI相比,MR-DTI可以定量化诊断腰肌损伤的严重程度。Objective To use magnetic resonance diffusion tensor imaging（MR-DTI） for auxiliarily diagnosing lumbar muscular strain. Methods Thirteen patients were enrolled who had experienced a lumbar muscle strain injury. Routine turbo spin echo-T1 weight imaging（T1）, turbo spin echo-T2 weight imaging-fat suppression（T2）, T1WI-based fat suppression contrast-enhanced（T1-CE） and auxiliary sequence of spin echo DTI MRI were acquired on a 3.0 T MRI system. The T2 and T1-CE signals and the DTI parameters of fractional anisotropy（FA）, apparent diffusion coefficient（ADC） and trace weight（TraceW） of the central and marginal areas of the injured region and the peripheral uninjured region were measured, and anatomy fractional anisotropy（Anat-FA） and muscle fiber tractography（MFT） maps of the injured region was performed.Results Changes in the severity of injury were correlated with decrease in FA, increases in ADC, TraceW and amplitude of the T2 and T1-CE signals. The areas of the T2 maps and the T1 contrast enhancement maps were not significantly different（P =0.42）, but the area of the Anat-FA map was significantly different from the T2 map（P〈 0.001） and the T1 contrast enhancement map（P =0.01）. MFT showed a consistent injury severity with that on T2 and T1-CE maps. Conclusion MRDTI assessing lumbar strain is more precisely than routine MRI, revealing the pathological and physiological changes in the strained muscle with a direct view and providing quantified information that are not observable using conventional MRI.

关 键 词：腰肌损伤 核磁共振成像 扩散张量成像 肌骨影像 

分 类 号：R685.4[医药卫生—骨科学]