腰椎管狭窄神经根沉降征判断与椎间隙扫描层面相关性研究  

The study of the relationship between the judgment of nerve root sedimentation sign in lumbar spinal stenosis and intervertebral scanning level

作　　者：王俊[1] 曹和涛[2] 万娟 刘婷婷[2] 侯冬梅[2] WANG Jun;CAO Hetao;WAN Juan;LIU Tingting;HOU Dongmei(Department of Medical Imaging,Funing People's Hospital,Funing,Jiangsu Province 224400,China;Department of Mecdical Imaging,lhe Affiliated Hospital of Nantong Unirversity,Nantong,Jiangsu Province 226001,China;Deparltment of Medical Imaging,Da feng People's Hospital,Dafeng,Jiangsu Province 224100,China)

机构地区：[1]阜宁县人民医院影像科,江苏阜宁224400 [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12期1994-1998,共5页Journal of Practical Radiology

摘　　要：目的分析比较不同方法判断神经根沉降征(NRSS)与椎间隙层面关系.方法随机收集68例腰椎管狭窄(LSS)患者MRI检查资料,选择L3~L4椎间隙3个连续横断面(头→足侧依次记为层1、层2和层3),以关节间隙顶点连线(方法1)及腰椎管有效矢状径等分线(方法2)作为参考线判断NRSS.神经根位于参考线腹侧判为NRSS阳性,背侧为阴性.测量3个层面硬膜囊面积(DCSA,按大→小记为层L、层M和层S),综合DCSA<100 mm2和临床症状判断LSS.LSS诊断率两两比较采用单因素方差分析,NRSS判断配对比较采用χ^(2)检验.结果68例L3~L4椎间隙层1~3神经根均可辨认,NRSS判断方法1:57例3个层面完全一致(χ^(2)=8.22,P<0.01);方法2:62例3个层面完全一致(χ^(2)=9.47,P<0.01).NRSS阴阳性例数比方法1为0.38,方法2为1.3(χ^(2)=8.44,P<0.01).依据NRSS判断阳性的层L、层M和层S,LSS诊断率方法1分别为49.5%、70.7%和90.4%(F=7.62,P<0.05);方法2分别为82.3%、88.6%和95.3%(F=2.49,P>0.05).NRSS阳性层面中层S LSS诊断率最高,其中方法1为90.4%,方法2为95.3%(χ^(2)=2.16,P>0.05);层L最低,其中方法1为49.5%,方法2为82.3%(χ^(2)=4.63,P<0.05).另外7例中有4例3个层面神经根均显示不清,DCSA<80 mm2,硬膜囊几乎全部位于关节突连线腹侧;3例2个层面神经根显示不清,另一层面NRSS均阳性.结论NRSS判断与椎间隙扫描层面无关,层S为NRSS判断和LSS评估的最佳层面,方法2优于方法1.Objective To analyze and compare the relationship between nerve root sedimentation sign(NRSS)judged by different methods and intervertebral levelMethods The data of 68 patients with lumbar spinal stenosis(LSS)examined by MRI were randomly ollcted.Three continuous cross section of L3-L4 intervertebral disc(from head to foot,layer;,layer2 and layer;were listed orderly)were selected.Take the line between the apex of the joint space(method,)and the bisector of the ffctive sagittal diameter of lumbar canal(method2)as the reference line to judge NRSS.NRSS was judged to be positive,when the nerve root located on the ventral side of the reference line,while the dorsal side was negative.To measure three dural sac cross-section area(DCSA)(from large to small,layer.,layerM and layers were marked),and combined DCSA less than 100 mm2 with clinical symptom to judge LSS.Single factor analysis of variance was used to compare the diagnostic rates of 1SS in pairs.The chi square test was used for the comparison of NRSS judgment pairs.Results The nerve roots at layer 1-3 of L3-L4 intervertebral disc were recognizable in 68 cases.If method;was used to judge NRSS,57 cases were completely consistent at three levels(χ^(2)=8.22,P<0.01).1f method2 was used to judge NRSS,63 cases were completely consistent at three levels(χ^(2)=9.47,P<0.01).The ratio of NRSS negative cases to positive cases was 0.38 in method;and 1.3 in method,(χ^(2)=8.44,P<0.01).According to the level L,M and S of NRSS positive,LSS diagnostic rate with method;was 49.5%,70.7%and 90.4%respectively(F=7.62,P<0.05),and with method2 was 82.3%,88.6%and 95.3%respetively(F=2.49,P>0.05).The LSS diagnosis rate of layer,was the highest in the NRSS positive level,ar mon;ng which method was 90.4%,method2 was 95.3%(χ^(2)=2.16,P>0.05);and the lowest was at the layer,,among which method;was 49.5%and method2 was 82.3%(χ^(2)=4.63,P<0.05).In the other 7 cases,nerve roots were all not identifiable at three layer in 4 cases,which DCSA<80 mm2 and dural sac was all located in the ventral of

关 键 词：神经根沉降征 椎管狭窄 硬膜囊 磁共振成像 

分 类 号：R745.4[医药卫生—神经病学与精神病学] R681.5[医药卫生—临床医学]