马尾神经冗余与腰椎滑脱关系的磁共振成像研究  

MRI study of the relationship of redundant nerve roots with lumbar spondylolisthesis

作　　者：朱小东 曹和涛[2] 侯冬梅[2] 万娟 刘婷婷[2] ZHU Xiaodong;CAO Hetao;HOU Dongmei;WAN Juan;LIU Tingting(Department of Imaging,the Third People's Hospital of Rugao,Rugao,Jiangsu Province 226500,China;Department of Radiology,the Affiliated Hospital of Nantong Unirversity,Nantong,Jiangsu Province 226001,China;Department of Radiology,Dafeng People's Hospital,Dafeng,Jiangsu Province 224100,China)

机构地区：[1]如皋市第三人民医院医学影像科,江苏如皋226500 [2]南通大学附属医院医学影像科,江苏南通226001 [3]大丰市人民医院影像科,江苏大丰224100

出　　处：《实用放射学杂志》2020年第8期1290-1293,共4页Journal of Practical Radiology

摘　　要：目的采用MRI技术研究马尾神经冗余(RNRs)与腰椎滑脱(LS)关系及其意义.方法收集253例MRI诊断为LS患者资料,在T2 WI矢状位观察马尾神经根形态,分为RNRs(+)和RNRs(-),测量其长度及最小硬膜囊面积(DSCA)并计算RNRs长度相对值.组间计量资料采用t检验,计数资料采用χ^2检验,等级资料采用单因素方差分析,进行Kappa一致性检验.结果253例中发现RNRs 42例(16.6%),其中真性LS 3例(4.47%),假性LS 39例(20.97%)(χ^2=11.59,P<0.01).Ⅰ~Ⅲ度真假性LS伴RNRs依次分别为0例、0例和3例及8例、27例和4例(F=10.26,P<0.05).假性LS L3~S1各层面伴RNRs分别为13例、24例和2例(F=15.34,P<0.05).Ⅰ、Ⅱ度假性LS伴/不伴RNRs各节段最小DSCA均有显著性差异(P<0.05).RNRs形态大致分"藤索"、"葡萄串珠"和"蛇纹石"3型,长度相对值分别为2.69±1.47、3.75±1.72和4.61±2.23(F=7.52,P<0.05).伴/不伴RNRs手术治疗率分别为40.48%(17/42)和21.33%(45/211)(χ^2=6.89,P<0.05).结论RNRs与LS类别、层面及滑脱程度相关,其形态和相对长度一定程度上反映LS伴腰椎管狭窄严重程度,可能是采取手术干预措施的重要征象.Objective To study the relationship between redundant nerve roots(RNRs)and lumbar spondylolisthesis(LS)by MRI technique.Methods The data of 253 cases diagnosed as LS by MRI were collected.In Tz WI sagittal plane RNRs were observed and dassfied by RNRs(+)and RNRs(-),the length of RNRs in the center of sagittal plane and the minimum dural sac cross sectional area(DSCA)were measured and the relative value of RNRs length was calculated.T-test was adopted in group measurement data,cnumeration data were compared with X2 test.The univariate analysis and Kappa identity test were applied to compare the differences of the ranked data.Results 42 cases(16.6%)with RNRs were found in 253 cases.Of which 3 cases(4.47%)with true LS,39 cases(20.97%)with pseudo LS(X^2=11.59,P<0.01).The ases ofⅠ-Ⅲtrue and pseudo LS with RNRs were 0,0,3 cases and 8,27.4 cases(F=10.26,P<0.05)in turn rectivey.The pseudo LS cases with RNRs in dfferent planeof L3-SI were 13,24 and 2 cases respectively(F=15.34,P<0.05).The mean values of the minimum DSCA at different segment of L3-L5 inⅠ,Ⅱpseudo LS with or without RNRs were all significantly dflent(P<0.05).The morphology of RNRs was roughly divided into three type of"vine","grape bead"and"serpentine",the relative values of length of RNRs were 2.69±1.47,3.75±1.72 and 4.61±2.23 respetively(F=7.52,P<0.05).The surgical treatment rates of the groups with or without RNRs were 40.48%(17/42),21.33%(45/211)(X^2=6.89,P<0.05).Concusion RNRs is related to the catgory,level and degree of LS,which shape and relative length reflecte the severity of LS with lumbar spinal stenosis to a certain degree。which may be an important sign for elinical surgical intervention.

关 键 词：马尾神经冗余 腰椎滑脱 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]