3.0T磁共振弥散张量成像在腰骶丛神经急性损伤的应用价值  

The application value of 3.0T MR diffusion tensor imaging in the acute injury of lumbar sacral plexus

作　　者：徐万里[1] 钱海峰[1] 吴晓[1] 刘东[1] 

机构地区：[1]浙江省湖州市中心医院放射科,浙江湖州313000

出　　处：《医学影像学杂志》2018年第2期258-262,共5页Journal of Medical Imaging

基　　金：浙江省湖州市科技局项目(编号:2014GY20)

摘　　要：目的探讨3.0T磁共振弥散张量成像(DTI)在腰骶丛神经急性损伤患者的临床应用价值。方法对15例经临床及影像学检查诊断的腰骶丛神经急性损伤患者,进行常规MRI以及DTI检查,通过设定感兴趣区域点对相应腰骶神经根进行纤维束成像,并测量L4~S1正常与损伤神经根的各向异性分数(FA)及表观扩散系数(ADC)值,采用ROC曲线分析神经根的FA值诊断神经损伤的阈值、敏感度、特异度和曲线下面积(AUC),相关性分析采用Pearson相关。结果DTI示踪技术能清晰显示腰骶丛神经根的走形特点。15例患者正常神经根的ADC值、FA值分别为(2.247±0.046)×10-3mm2/s和0.208±0.013,损伤神经根的ADC值和FA值分别为(2.753±0.051)×10-3mm2/s和0.176±0.017。损伤神经根的ADC值明显高于正常神经根,损伤神经根的平均FA值明显低于正常神经根。ROC曲线分析显示FA值≤0.197时,诊断腰骶丛损伤神经根的AUC、敏感度和特异度分别为0.885、70.8%和91.6%。结论与常规MRI相比,DTI对腰骶丛神经损伤患者的诊断提供定量化及直观的影像学依据。Objective To investigate the clinical value of MRI diffusion tensor imaging （DTI） in patients with acute lumbar sacral plexus injury. Methods 15 patients of acute lumbosacral plexus injury diagnosed by clinical and imaging examination were performed routine MRI and DTI examination. The fiber bundle imaging was performed on the corresponding lumbosacral nerve root by setting the region of interest and the anisotropy fraction （FA） and the apparent diffusion coefficient （ADC） of L4 - S1 normal and injured nerve root were measured, Receiver operating characteristic （ROC） curve analysis was performed for evaluation of the sensitivity, specificity and AUC. Pearson correlation analysis test was used to analysis correlation. Results DTI tracer technique can clearly display the shape features of lumbosacral plexus nerve root. The ADC and FA value of the normal nerve roots in 15 Pa- tients were （2. 247±0.046）×10^-3mm^2/s and 0. 208 ± 0. 013, respectively. The ADC and FA value of the injured nerve root were （2. 753 ±0.051）×10^-3mm^2/s and 0. 176 ±0. 017. The ADC value of the injured nerve root was significantly higher than that of the normal nerve root, and the average FA value was significantly lower than that of the normal nerve root. ROC curve anal- ysis showed that the FA value ≤0. 197, the diagnosis of lumbosacral plexus injury nerve root AUC, sensitivity and specificity were 0. 885, 70.8% and 91.6%. Conclusion Compared with conventional MRI, DTI provides quantitative and intuitional ima- ging evidence for the diagnosis of lumbosacral plexus injury.

关 键 词：磁共振成像 弥散张量成像 腰骶丛 神经损伤 

分 类 号：R745.4[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]