仰卧位和俯卧过屈位磁共振扩散张量成像对腰椎间盘突出症分型的研究  

Evaluation of lumbar disc herniation by MR diffusion tensor imaging in supine and prone flexed posture

作　　者：闫春丽 郗玉珍 刘淼[1] 周敏[1] 陈兴灿[1] YAN Chun-li;XI Yu-zhen;LIU Miao;ZHOU Min;CHEN Xing-can(Department of Radiology,the 903th Hospital of PLA,Hangzhou 310013,China)

机构地区：[1]中国人民解放军联勤保障部队第903医院放射科,浙江杭州310013

出　　处：《中国临床医学影像杂志》2021年第8期592-596,共5页Journal of China Clinic Medical Imaging

基　　金：杭州市社会发展科研自主申报项目(20170533B100)。

摘　　要：目的:研究仰卧位和俯卧过屈位磁共振扩散张量成像(Diffusion tensor imaging,DTI)对腰椎间盘突出症(LDH)的分型。方法:20例22个突出椎间盘接受骨科手术治疗,所有患者分别进行仰卧位和俯卧过屈位常规配对MRI和配对DTI检查;采用DTI的B_(0)图及其纤维示踪(Fiber tracking,FT)技术重建FT图;LDH分为包容性和非包容性2种类型;用A(配对MRI)和B(配对MRI结合配对DTI)两种方法进行诊断,采用SPSS 24.0软件包进行统计学分析,使用Spearman相关性分析检验两种方法诊断结果与手术结果的相关性,P<0.05为差异有统计学意义。结果:22个突出椎间盘手术结果显示包容性10个、非包容性12个。方法A诊断包容性突出椎间盘5个,表现为椎间盘后缘纤维环完整,与硬囊分界清楚,突出回复征象明显;非包容性突出椎间盘17个,表现为椎间盘后缘模糊或破裂,与硬膜囊及周围组织分界不清,无明显突出回复征象。方法B诊断包容性突出椎间盘9个,表现为B_(0)图信号及FT图形态改变明显;非包容性突出椎间盘13个,表现为B_(0)图信号及FT图形态无明显改变。方法A和B诊断结果与手术结果都呈正相关(R_(A)=0.594,P=0.01<0.05;R_(B)=0.911,P=0.0001<0.05)。结论:仰卧位和俯卧过屈位配对MRI结合配对DTI对LDH的分型具有重要价值,对LDH患者临床治疗方案的选择具有重要意义。Objective:To investigate the classification of lumbar disc herniation(LDH)by MRI and diffusion tensor imaging(DTI)in supine and prone flexed posture.Methods:Twenty-two LDH of 20 patients selected underwent surgical therapy.Every patient underwent MRI and DTI scan in supine and prone flexed posture in pair.The fiber tracking(FT)maps were reconstructed based on the DTI data.All herniated discs were divided into two groups as contained and noncontained LDH;A(paired MRI)and B(paired MRI combined with paired DTI)were used for diagnosis.Spearman correlation analysis was used to analyze the correlation between the two methods and surgical results.SPSS 24.0 software was used for statistical analysis,with a statistical significance of P<0.05.Results:In 22 herniated discs,10 contained LDH and 12 noncontained LDH were proved by operation.Five contained LDH(the herniation coming back significantly)and 17 noncontained LDH(the herniation no coming back)were diagnosed by Method A.Nine contained LDH(the signal of B_(0) map and the morphological characteristics of FT map all changing)and 13 noncontained LDH(the signal of B_(0) map and the morphological characteristics of FT map having no change)were diagnosed by Method B.The diagnosis of method A and B had positive relationship with the result proved by operation(R_(A)=0.594,P=0.01<0.05;R_(B)=0.911,P=0.0001<0.05).Conclusion:Lumbar MRI combined with DTI in supine and prone flexed posture in pair has important value for the classification of LDH,and play a role in choosing clinical treatment method for the patients with LDH.

关 键 词：椎间盘移位 磁共振成像 

分 类 号：R681.53[医药卫生—骨科学] R445.2[医药卫生—外科学]