磁共振SPACE-STIR序列在腰骶神经根病变中的应用  

Application of MRI SPACE-STIR sequence in lumbosacral radiculopathy

作　　者：许道洲[1] 夏好成[1] 吕海莲[1] 罗树彬[1] 许蕾[1] 肖文丰[1] 许志茂[1] 张明[1] 井源[2] 

机构地区：[1]山东省东营市胜利油田中心医院磁共振科,山东东营257034 [2]山东省东营市胜利油田中心医院保健科,山东东营257034

出　　处：《医学影像学杂志》2014年第10期1816-1819,1823,共5页Journal of Medical Imaging

摘　　要：目的探讨磁共振SPACE-STIR序列在腰骶神经根病变中应用价值。方法回顾性分析了190例因腰腿痛进行磁共振检查患者的常规磁共振(CMRI)及SPACE-STIR扫描图像,根据磁共振诊断对190例患者做病因学统计;对手术证实的56例60个椎间盘,比较CMRI和SPACE-STIR诊断阳性率、统计常规分型;对手术证实的57个有神经根受累椎间盘,行SPACE-STIR分型与手术分型比较。采用SPSS 13.0统计学软件对CMRI和SPACE-STIR诊断阳性率进行配对资料的卡方检验,一致性资料采用Kappa一致性检验。结果190例腰腿痛患者中椎间盘突出139例,占73.16%,为腰腿痛的主要病因。CMRI与CMRI+SPACE诊断阳性率分别是87.5%、93.3%,差异具有统计学意义(P=0.016)。SPACE-STIR分型与手术分型具有很好的符合性(kappa=0.906,P=0.000)。结论 SPACE-STIR序列使得病灶与神经鞘的解剖关系更加明确,对腰骶神经根病变的病因诊断、诊断阳性率的提高以及临床制定恰当的治疗方案提供了重要的信息。Objective To investigate the application value of MRI SPACE-STIR sequence in lumbosacral radiculopathy . Methods The MRI images with routine scan and images from SPACE sequence of 190 patients with lumbocrural pain were analyzed retrospectively .Etiology statistic was made according to MRI diagnosis .We compared positive rate between rou-tine scan and SPACE-STIR sequence with 60 intervertebral disk in 56 cases proved by operation .We also compared the types by SPACE-STIR sequence with operation in 57 intervertebral disk with injury of nerve root proved by operation .The positive rate of routine scan and SPACE-STIR sequence were analyzed by chi-square statistics using SPSS 13.0 software . Results Protrusion of intervertebral disc accounted for 73 .16% in this group . The positive rate of routine scan and SPACE-STIR sequence was 87 .5% and 93 .3% respectively .The difference was statistically significant （ P = 0.016） . The coincidence of SPACE-STIR type and operation was 96 .5 % （ kappa=0 .906 ,P=0 .000） .Conclusion The SPACE-STIR sequence showed anatomical position between focus and neurilemma more definite and accurate .It provided impor-tant information for etiological diagnosis of lumbosacral radiculopathy ,elevation of positive rate ,thus making proper ther-apeutic schedule .

关 键 词：磁共振成像 SPACE-STIR序列 腰骶神经根 病变 椎间盘 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]