磁共振扩散张量成像在急性横贯性脊髓炎微结构变化中的应用  

The applied study of MR diffusion tensor imaging in microstructure changes of acute transverse myelitis

作　　者：郑淞文[1] 郎志谨[2] ZHENG Songwen;LANG Zhijin(Department of Radiology,Dalian Central Hospital,Dalian,Liaoning Province 116033,China;Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province 116011,China)

机构地区：[1]大连市中心医院放射科,辽宁大连116033 [2]大连医科大学附属第一医院放射科,辽宁大连116011

出　　处：《实用放射学杂志》2020年第9期1371-1373,1387,共4页Journal of Practical Radiology

摘　　要：目的探讨MR-DTI在急性横贯性脊髓炎(ATM)微结构变化中的应用价值.方法选取36例ATM患者(病例组)及36例健康志愿者(对照组),均行常规MRI及MR-DTI扫描,比较2组病变水平、病变近端T2WI"显示正常"脊髓水平(PNSCL)和病变远端T2WI"显示正常"脊髓水平(DNSCL)的FA值、平均扩散率(MD)值,观察ATM患者常规MRI与MR-DTI各组参数图变化.结果病例组病变水平、PNSCL、DNSCL的FA值较对照组均明显减低,有显著性差异(P<0.01或P<0.05),DNSCL的FA值较PNSCL降低更明显;2组病变水平、PNSCL、DNSCL的MD值相比,差异均无统计学意义(P>0.05);纤维束成像(DTT)示病变脊髓纤维排列明显疏松、紊乱、变形.结论MR-DTI较常规MRI对诊断ATM更为敏感,能发现T2WI显示正常信号的区域的脊髓节段存在的异常,DTT可直观显示脊髓纤维束微结构的形态学改变.Objective To explore the applied value of MR-DTI in microstructure changes of acute transverse myelitis(ATM).Methods 36 patients with ATM and 36 cases of healthy volunteers were brought into case group and control group respectively.The two groups were scanned by conventional MRI and MR-DTI.FA values of lesion,proximal normal appearing spinal cord level(PNSCL)and distal normal appearing spinal cord level(DNSCL)were compared between the two groups,as well as mean diffusivity(MD)values were done simultaneously.The images of conventional MRI and parameters of MR-DTI for the ATM were observed.Results The FA values of lesion,PNSCL and DNSCL for the case group were lower than that for the control group(P<0.01 or P<0.05),compared with PNSCL,DNSCL dropped apparently.There were no significant difference on MD values of lesion,PNSCL and DNSCL between the two groups(P>0.05).Diffusion tensor tractography(DTT)showed that all of the abnormal areas of the white matter fiber bundles of the patients with rarefaction,disorder and deformation.Conclusion The sensitivity of MR-DTI is higher than conventional MRI when diagnosing ATM.It can show the abnormal signs in the segmental spinal cord when the T2WI shows normal.DTT can visually display the morphological changes in microstructure of spinal cord.

关 键 词：急性横贯性脊髓炎 磁共振成像 扩散张量成像 

分 类 号：R744.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]