腰椎间盘突出受压神经的DTI参数与神经根疼痛的相关性研究  

Correlation study between compressed nerve DTI parameters and nerve root pain in lumbar disc herniation

作　　者：陈镜聪[1] 钟瑜[1] 刘贵华 曾祥灵 翟少智[1] 陈康胤 蓝博文[1] CHEN Jingcong;ZHONG Yu;LIU Guihua;ZENG Xiangling;ZHAI Shaozhi;CHEN Kangyin;LAN Bowen(Department of Radiology,Huizhou Central People’s Hospital,Huizhou 516001,China)

机构地区：[1]广东省惠州市中心人民医院放射科,广东惠州516001 [2]广东省惠州市中心人民医院脊柱外科,广东惠州516001

出　　处：《中国中西医结合影像学杂志》2022年第5期479-482,486,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：惠州市科技计划项目(20210415)。

摘　　要：目的:探讨DTI对腰椎间盘突出受压神经损伤情况的诊断价值,并分析DTI参数与神经根疼痛的相关性。方法:选取经临床诊断及MRI平扫显示为单侧神经根受压的腰椎间盘突出症患者73例,均行DTI检查,测量各向异性分数(FA)值、ADC值、神经纤维束长度及密度指数,并采用视觉模拟评分法(VAS)进行疼痛分级;比较腰椎间盘突出L_(4)~S_(1)神经根受压侧与健侧之间上述各参数的差异;分析受压侧DTI参数与VAS评分的相关性。结果:73例患者中,受压侧神经根与健侧对应神经根FA值、纤维束长度及密度指数比较,差异均有统计学意义(均P<0.05);ADC值比较,差异无统计学意义(P>0.05)。VAS评分:27例为轻度,38例为中度,8例为重度,轻、中、重度患者的FA值、神经根纤维束长度及密度指数差异均有统计学意义(均P<0.05),ADC值差异无统计学意义(P>0.05)。FA值、受压神经根纤维束长度及密度指数均与VAS评分均呈负相关(r=-0.881,-0.540,-0.803;均P<0.05);ADC值与VAS评分无相关性(r=-0.095,P>0.05)。结论:腰椎间盘突出受压神经的DTI参数,即FA值、纤维束长度及密度指数发生改变,且与VAS评分具有相关性,可评价腰椎间盘突出致神经根受压程度。Objective:To explore the diagnostic value of DTI to compressed nerve injury in lumbar disc herniation,and analyze the correlation between DTI parameters and nerve root pain.Methods:Seventy-three patients with lumbar disc herniation were selected who were clinically diagnosed with unilateral nerve root compression on plain MRI scans.DTI scans were performed.The fractional anisotropy(FA),ADC,nerve fiber bundle length and density index were measured,and the orthopedic visual analog system(VAS)score was used for pain grading.The differences in the FA value,ADC value,nerve fiber bundle length and density index between the compressed side and the contralateral side of the L_(4)~S_(1) nerve root of lumbar disc herniation were compared,and the correlation between the compressed side tensor parameter value and VAS score was analyzed.Results:Among 73 patients with lumbar disc herniation,there were significant differences in FA value,nerve fiber bundle length and density index between the nerve root on the compression side and the corresponding nerve root on the healthy side(all P<0.05),and the ADC value was not significantly different(P>0.05).The VAS score was mild in 27 cases,moderate in 38 cases and severe in 8 cases.There were significant differences in FA value,nerve root fiber bundle length and density index among the mild,moderate and severe level of in VAS score(all P<0.05),and ADC value had no difference(P>0.05).FA value,nerve root fiber length and density index on the compression side were negatively correlated with VAS score(r=-0.881,-0.54,-0.803,all P<0.05),while ADC value was not correlated with VAS score(r=-0.095,P>0.005).Conclusion:In the tracing imaging of compressed nerve fibers in lumbar disc herniation,the FA value,fiber bundle length and density index can be changed,which are correlated with the VAS score and can jointly evaluate the severity of nerve root compression caused by lumbar disc herniation.

关 键 词：纤维示踪 磁共振成像 腰骶神经根 疼痛 

分 类 号：R681.53[医药卫生—骨科学]