DTI评价非压迫性腰椎神经根炎微创治疗价值的实验研究  

Research study on DTI evaluation of non-compressive lumbar radiculitis after CT-guided minimally invasive treatment

作　　者：牛翔科 肖建明[1] 杨朝炳 植彪 王宗勇[1] 彭涛[1] 

机构地区：[1]成都大学附属医院放射科,四川成都610081

出　　处：《中国中西医结合影像学杂志》2017年第5期547-550,555,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：四川省医学科研青年创新课题计划(Q14004)

摘　　要：目的 :探讨非压迫性腰椎神经根炎经CT导向下微创治疗后神经根病理转归及神经根DTI的各向异性分数(FA)值的变化。方法:巴马小型猪9只经CT导向下非压迫性神经根炎造模成功14 d后,根据治疗药物不同随机分为3组。分别于实验猪L_(2~3)、L_(3~4)及L_(4~5)双侧神经根旁注入相应药物进行治疗。每组分别于术后3、7及14 d行DTI扫描,扫描完成后处死实验动物,取相应双侧神经根行免疫组织化学检查。采用单因素方差分析术后3、7、14 d神经根FA值及神经根TNF-α平均光密度值的组间、组内差异;Spearman相关性分析神经根FA值与神经根TNF-α平均光密度值之间的关系。结果:消炎液治疗组神经根FA值及TNF-α平均光密度值治疗后下降趋势最明显;脉络宁治疗组于治疗后14 d神经根FA值及TNF-α平均光密度值与生理盐水组比较差异均有统计学意义(均P<0.05)。神经根FA值与TNF-α平均光密度值之间呈负相关。结论:CT导向下硬膜外注射消炎液可改善实验猪非压迫性神经根炎的炎症程度,且FA值可作为无创性客观评价其病理转归的手段。Objective：To explore the pathological changes of non-compressive radiculitis after CT-guided treatment,and also e-valuate the changes of DTI parameters in lumbar nerve root. Methods：9 pigs with CT-guided induced non-compressive radiculi-tis were divided into three groups with 3 swine in each group based on implemented treatment methods. Bilateral epidural nerve root injection,at segments L2~3,L3~4,and L4~5,of specific therapeutic materials were injected into the respective groups. Thereafter,each group underwent postoperative （at 3,7 and 14 days） DTI MRI scan,and immunohistochemical study was performed on nerve root specimens. Analysis of each group in the postoperative FA value and nerve root immunohistochemical changes,the correlation between FA value and immunohistochemical changes were also analyzed. Results：There were declining trend that have been observed in nerve root FA value and TNF-α average optical density values after anti-inflammatory liquid treatment. After 14 days,the FA value and TNF-α average optical density value of Mailuoning treatment group showed statistical signifi-cance then compared with saline group. Furthermore,FA value of nerve root and immunohistochemical changes were correlated negatively. Conclusions：Nerve root inflammation could be improved by anti-inflammatory liquid treatment,and DTI could be used as a non-invasive monitoring tool for non-compressive radiculitis after minimal invasive treatment.

关 键 词：腰椎 椎间盘移位 扩散张量成像 神经根病 外科手术 微创性 模型 动物 免疫组织化学 

分 类 号：R681.5[医药卫生—骨科学] R816.8[医药卫生—外科学]