磁共振扩散张量成像在评价脊神经根病变中的作用  

The application of magnetic resonance diffusion tensor imaging in the evaluation of spinal nerve root lesions

作　　者：闵朋 杨锐 

机构地区：[1]湖北医药学院附属东风医院磁共振室,湖北十堰442000

出　　处：《中国临床研究》2018年第2期252-255,共4页Chinese Journal of Clinical Research

基　　金：十堰市科学技术研究与开发项目(14Y56)

摘　　要：目的探讨磁共振扩散张量成像(DTI)在评价脊神经根病变中的作用。方法选取2014年1月到2015年12月收治的62例腰椎间盘突出、膨出导致脊神经根病变患者,对其进行核磁共振矢状位T1WI、T2WI,轴位T2WI和DTI检查。结果共有27例患者病变侧神经根发生移位,17例病变侧神经纤维局部变细,9例纤维束局部有缺失,4例无法追踪到腰骶神经根的在椎管内穿行的上行段,2例无受压的神经根。相对于健康侧神经根,病侧神经根排列不规则且稀疏,细小神经纤维穿插增多。腰间盘突出症患者病侧神经根表观弥散系数(ADC)均值为(1.769±0.489)×10^(-3)mm^2·s^(-1),高于健侧同一椎间盘水平的神经根[(1.466±0.451)×10^(-3)mm^2·s^(-1),t=3.587,P<0.01];各向异性指数(FA)的均值为(0.251±0.032)×10^(-3),低于健侧同一椎间盘水平的神经根[(10.329±0.026)×10^(-3),t=14.896,3.587,P<0.01]。结论磁共振扩散张量成像可作为常规磁共振很好的补充,它能够对神经根进行功能成像从而定量评价神经根病变,并且有望可以利用DTI根据神经纤维束的面积以及形态的改变,从而诊断神经根病变。Objective To investigate the application of magnetic resonance diffusion tensor imaging（ MR DTI） in the evaluation of spinal nerve root lesions. Methods Sixty-two patients with spinal nerve root lesions（ due to lumbar disc herniation） and 62 healthy volunteers from January 2014 to December 2015 were selected. All of them were received MR T1-weighted and T2-weighted imaging at sagittal position and T2-weighted imaging and DTI at axial position. Results There were 22 cases displaced on the lateral nerve root of the lesion,17 cases localized in the lateral nerve fibers,9 cases localized in the fibrous tract,4 cases unable to track the upper segment of the lumbosacral nerve root in the spinal canal,and 2 cases without compressed nerve root. Compared to the lateral nerve root of healthy side,the nerve root of the lesioned side was irregular and sparsely arranged,and there were fine nerve fibers interspersed. The mean apparent diffusion coefficient（ ADC） value of the lateral nerve root of the lumbar disc herniation was higher than that of the same level disc in the healthy side [（ 1. 769 ± 0. 489） × 10^-3 mm^2/s vs（ 1. 466 ± 0. 451） × 10^-3 mm^2/s,t = 3. 587,P〈0. 01]. And the mean fractional anisotropy（ FA） value of the lateral nerve root of the lumbar disc herniation was lower than that of the same level disc in the healthy side [（ 0. 251 ± 0. 032） × 10^-3 vs（ 0. 329 ± 0. 026） × 10^-3,t = 14. 896,P〈0. 01]. Conclusions MRI DTI could be a good supplement to conventional MRI,which could perform functional imaging of nerve roots and quantitatively evaluate nerve root lesions. It is hopeful that DTI can be used to diagnose nerve root lesions based on the area and morphological changes of nerve fiber bundles.

关 键 词：神经根病变 退行性病变 磁共振 扩散张量成像 示踪 表观弥散系数 各向异性指数 

分 类 号：R445.2[医药卫生—影像医学与核医学]