受压神经根微观结构的变化与临床症状及持续时间的相关性分析  

Microstructural changes in compressed nerve roots being consistent with clinical symptoms and symptom duration

作　　者：梁杰[1] 陈爱华[2] 武斌[1] 张婷婷[2] 伍伟飞[1] 

机构地区：[1]三峡大学人民医院(宜昌市第一人民医院)骨科,湖北宜昌443000 [2]三峡大学人民医院(宜昌市第一人民医院)放射科,湖北宜昌443000

出　　处：《中国骨与关节损伤杂志》2016年第11期1140-1142,共3页Chinese Journal of Bone and Joint Injury

基　　金：宜昌市卫生科研课题(A16-301-19)

摘　　要：目的基于MRI的弥散张量成像(DTI)技术,探讨腰椎间盘突出症患者受压神经根部分各向异性(FA)、表观扩散系数(ADC)的变化,以及FA、ADC值与ODI指数和症状持续时间的相关性。方法应用1.5T MRI的DTI成像序列,观察35例腰椎间盘突出症导致单侧S1神经根受压患者的FA、ADC值,比较受压神经根与对侧神经根FA值、ADC值之间差异,分析FA、ADC值与ODI指数和症状持续时间的相关性。结果受压神经根FA值为0.153±0.029,对侧神经根FA值为0.254±0.041;受压神经根FA值明显低于对侧神经根FA值,差异有统计学意义(t=-11.885,P<0.001)。受压神经根ADC值为1.439±0.233,对侧神经根的ADC值为1.378±0.280,差异无统计学意义(t=1.008,P=0.317)。受压神经根FA值与ODI指数(r=-0.963,P<0.001)、症状持续时间(r=-0.872,P<0.001)呈明显的负相关。受压神经根ADC值与ODI指数(r=0.489,P=0.001)、症状持续时间(r=0.348,P=0.020)呈正相关。结论受压神经根DTI较常规MRI能够准确地量化神经根微观结构改变,可以为临床医师更早治疗腰椎间盘突出症提供有利的影像学依据。Objective To investigate changes of the mean fractional anisotropy （FA） and apparent diffusion coefficient（ADC） values of compressed nerve root by diffusion tensor imaging（DTI）, and analyze the association between FMADC values and the Oswestry disability index （ODI） and their duration in patients with lumbar disc herniation （LDH）. Methods Thirty-five consecutive patients with foraminal disc herniation affecting unilateral S1 nerve roots were enrolled in this study, 1.5 T MRI- DTI was performed on the S1 nerve roots. The difference of FMADC values between compressed side and normal side was compared. Correlation between FMADC value and ODI and duration was analyzed. Results The mean FA value of the compressed lumbar nerve roots was 0.153±0.029, which was significantly lower than the FA of the contralateral nerve roots （0.254±0.041）. No significant difference in ADC was observed between compressed nerve roots （1.439±0.233） and the contralateral nerve root （1.378±0.280）. In the compressed nerve roots, a significant negative association was observed between FA values and ODI（r =-0.963, P 〈0.001） and symptom duration（r =-0.872, P 〈0.001）. However, an obvious positive association was observed between ADC values and ODI （r =0.489, P =0.001） and duration （r =0.348, .P =0.020） on the compressed side. Conclusion Compared with conventional MRI of nerve roots, DTI could accurately quantify the changes of microstructure in patients with LDH. And DTI could provide a more effective radiograph basis for clinicians to treat LDH earlier.

关 键 词：椎间盘突出症 MRI弥散张量成像 受压神经根 部分各向异性 表观扩散系数 

分 类 号：R681.5[医药卫生—骨科学]