腰椎间盘突出症MRI分级与F波及H反射的相关性  

Correlation between the MRI-based grading system and F wave as well as H-reflex in patients with lumbar disc herniation

作　　者：栗晓[1] 林彩娜[1] 罗海杰[1] 万青[1] 阮玉婷[1] 张新胜[1] 伍少玲[1] 马超[1] 

机构地区：[1]中山大学孙逸仙纪念医院康复医学科,广东省广州市510120

出　　处：《中国组织工程研究》2016年第42期6343-6350,共8页Chinese Journal of Tissue Engineering Research

基　　金：广东省医学科学技术研究基金资助项目(A2015308);项目名称:TRPV1对CGRP的作用及在腰椎退变所致慢性腰痛的机制研究~~

摘　　要：背景:腰椎MRI检查及神经电生理检测对腰椎间盘突出所致的神经根损害具有重要的诊断评估价值。目的:分析腰椎间盘突出症患者腰椎MRI分级与F波潜伏期、出现率以及H反射潜伏期、波幅之间的相关性。方法:采用飞利浦achieva 3.0T超导型MRI仪和腰椎专用TCL线圈对腰椎间盘突出症患者的腰椎进行扫描,通过MRI扫描图像对患者突出椎间盘大小以及神经根受压程度进行分级评分;采用牛津肌电诱发电位仪对患者双侧下肢胫神经进行F波和H反射检测。结果与结论:(1)Spearman相关分析结果表明,腰椎间盘突出症患者的MRI分级评分与F波出波率呈负相关(r=-0.594 0,P<0.000 1),与F波潜伏期呈正相关(r=0.825 6,P<0.000 1),与H反射波幅无明显相关性(r=-0.117 4,P=0.257 3),与H反射潜伏期呈正相关(r=0.875 0,P<0.000 1);(2)随着MRI分级评分的增高,F波出波率逐渐降低,F波和H反射潜伏期逐渐延长,提示患者神经根出现损害,且损伤程度逐渐加重。BACKGROUND：Lumbar spine MRI and electrophysiological test are reliable methods for evaluating nerve root injury caused by lumbar disc herniation. OBJECTIVE：To analyze the correlation between the MRI-based grading system and the latency and frequency of F wave as wel as latency and amplitude of H-reflex in patients with lumbar disc herniation. METHODS：MRI imaging of the lumbar spine was performed with a 3.0-T imager and a dedicated TCL coil to classify lumbar disc herniation and nerve root compression. F wave and H reflex were detected on the patient bilateral tibial nerves using Oxford myoelectricity evoked potential instrument. RESULTS AND CONCLUSION：Spearman correlation analysis showed that the MRI-based grading of patients with lumbar disc herniation had a negative correlation with F wave frequency （r=-0.594 0, P〈0.000 1）, and a positive correlation with F wave latency （r=0.825 6, P〈0.000 1） and H-reflex latency （r=0.875 0, P〈0.000 1）, but no correlation with H-reflex amplitude （R=0.117 4, P=0.257 3）. With MRI grading increased, F wave frequency was decreased, and F wave and H-reflex latency were prolonged gradual y, indicating aggravating nerve root compression.

关 键 词：腰椎 椎间盘移位 经皮神经电刺激 组织工程 组织构建 骨组织工程 腰椎间盘突出症 神经电生理 MRI F波 H反射 相关性研究 

分 类 号：R318[医药卫生—生物医学工程]