磁共振扩散张量成像定量评价消炎液微创治疗非压迫性腰椎神经根炎  

Quantitative evaluation of anti-inflammatory minimally invasive surgery of non-compressive lumbar radiculitis with diffusion tensor imaging

作　　者：杨朝炳 吕赛群[1] 彭涛[1] 牛翔科 植彪 肖建明[1] YANG Chaobing;LYU Saiqun;PENG Tao;NIU Xiangke;ZHI Biao;XIAO Jianming(Department of Radiology,The Affiliated Hospital of Chengdu University,Chengdu 610081,China)

机构地区：[1]成都大学附属医院放射科,四川成都610081

出　　处：《西部医学》2022年第4期504-508,共5页Medical Journal of West China

基　　金：成都市卫健委项目(2020177)。

摘　　要：目的探索利用消炎液微创治疗腰椎非压迫性神经根炎的动物实验方法,并运用磁共振扩散张量成像(DTI)对其疗效进行定量评价。方法将6只巴马小型猪分为两组,通过CT导向下于L2~3、L3~4及L4~5神经根旁硬膜外注入自体髓核组织造模。造模后14天,实验组神经根旁注入10 mL消炎液治疗,对照组注入10 mL生理盐水。两组治疗后3、7、14天各取1只实验猪处死,解剖相应神经根行TNF-α蛋白含量免疫组织化学检查。造模前、治疗前、神经根取材前均行DTI检查。比较两组造模前、治疗前及治疗后各时间点神经根FA值变化及治疗后神经根TNF-α蛋白含量的变化。结果造模后两组神经根FA值均减小(均P<0.05);实验组治疗后各时间点神经根FA值回升(P<0.05),而对照组无变化(P>0.05);实验组相应神经根FA值均高于对照组(均P<0.05)。实验组治疗后7、14天神经根TNF-α蛋白含量降低且低于对照组(P<0.05),而对照组治疗后各时间点无变化(P>0.05)。结论消炎液微创治疗腰椎非压迫性神经根炎有效,并能用DTI进行评价。Objective To explore the animal experimental method(AEM)of minimally invasive surgery(MIS)of non-compressive lumbar radiculitis with anti-inflammatory liquid,and evaluate its efficacy with diffusion tensor imaging(DTI)quantitatively.Methods To establish non-compressive lumbar radiculitis model,we injected suspension,coming from autologous nucleus pulpous of 6 Bama miniature pigs.The pigs were divided into two groups(experimental group and control group)randomly into epidural space pararadically at the level of intervertebral foramen of L_(2~3) and L_(3~4)as well as L_(4~5)by CT-guided puncture respectively.14 days later,we inject anti-inflammatory liquid with same dose into the epidural space in experimental group and normal saline in control group respectively at the same level.Another 3 days and 7 days as well as 14 days later,one piggy in the two groups was sacrificed randomly respectively for TNF-αimmunohistochemical study of the nervous root.DTI has been done pre-modeling and prior treatment as well as before sacrifice.Statistic analyses of FA value of the nervous roots had been implemented at the point of execution above,and of TNF-αvalue post-injection of suspension of anti-inflammation or saline as well.Results With comparison to during pre-modeling period,the FA values of nerve roots are reduced significantly(P<0.05)during post-modeling period in two groups.But,the FA values of nerve roots are elevated gradually in the experimental group on the other hand in the control group are kept non-variable on the 3 days and 7 days as well as 14 days after injection(P>0.05),and are higher(P<0.05)in the experimental group than in the control group at the same date.On the date of 7 and 14,TNF-αvalue in the experimental group was decreased(P<0.05).The pigs were and lower than in the control group(P<0.05)on the other hand it kept stable in the control group(P>0.05).Conclusion MIS of non-compressive lumbar radiculitis with anti-inflammatory liquid is effective and,can be evaluated with DTI quantitatively.

关 键 词：腰椎间盘突出 扩散张量成像 神经根性炎 微创治疗 免疫组织化学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.53[医药卫生—诊断学]