下腰痛患者椎间盘DTI的影像学分析  

Imaging analysis of disc DTI in patients with low back pain

作　　者：孙若愚 王林林 贺克武 张振华 SUN Ruoyu;WANG Linlin;HE Kewu;ZHANG Zhenhua(Department of Radiology,The Third Affiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第三附属医院放射科,安徽合肥230000

出　　处：《医学影像学杂志》2022年第12期2150-2154,共5页Journal of Medical Imaging

摘　　要：目的探讨下腰痛患者椎间盘突出、局限性高信号区(HIZ)与相应椎间盘DTI影像学特征。方法选取在我院60例行腰椎MRI检查表现为椎间盘突出、局限性高信号(HIZ)阳性患者相应椎间盘DTI扫描的影像资料,并与正常椎间盘对照分析。结果A组30例局限性高信号(HIZ)阳性的椎间盘DTI多表现为局限性纤维环撕裂,相应FA数值减低及ADC值增加,FA值范围为0.221~0.356±0.096,平均数0.295±0.073,ADC范围为1.352~1.868±0.218,平均数为1.527±0.202;B组30例腰4~5椎间盘突出患者,其椎间盘DTI显示27例纤维环完全撕裂达边缘,伴有髓核溢出,3例为纤维环局限性撕裂未达边缘,相应FA数值为0.204~0.301±0.107,平均数为0.275±0.083,ADC值为1.313~1.768±0.165,平均数1.482±0.234;对照组C组30例健康无症状志愿者腰4~5椎间盘DTI表现为FA数值0.328~0.491±0.088,平均数0.403±0.137,ADC值为1.191~1.417±0.265,平均数为1.236±0.319;A与C、B与C组间差异具有统计学意义(P<0.05),而A与B组间差异无统计学意义(P>0.05)。结论DTI可以直观定量分析纤维环撕裂的影像学特征;椎间盘撕裂部位较正常表现为神经纤维数量显著减少,相应FA数值减低及ADC值增加,差异具有统计学意义;椎间盘局限性高信号区(HIZ)的出现是提示纤维环撕裂的可靠征象。Objective To investigate the DTI imaging features of disc herniation and High intensity zone(HIZ)in patients with low back pain.Methods The DTI imaging data of patients with lumbar disc herniation and High intensity zone(HIZ)positive were collected and compared with normal intervertebral discs.Results In group A,most of the 30 HIZ positive discs showed localized annulus fibrosus tear on DTI,and the corresponding FA value decreased and ADC value increased,with the FA value ranging 0.221~0.356±0.096,with an average of 0.295±0.073,ADC value ranging 1.352~1.868±0.218,with an average of 1.527±0.202;In group B,there were 30 patients with L4~5 disc herniation,in which disc DTI showed that 27 cases of complete tear of annulus fibrosus reached the edge,accompanied by nucleus pulposus overflow,and 3 cases of localized tear of annulus fibrosus did not reach the edge.The corresponding FA value was 0.204~0.301±0.107,with an average of 0.275±0.083,ADC value was 1.313~1.768±0.165,with an average of 1.482±0.234;In group C,30 healthy volunteers with asymptomatic L4~5 disc DTI showed FA value of 0.328~0.491±0.088,with an average of 0.403±0.137,ADC value was 1.191~1.417±0.265,with an average of 1.236±0.319;There were significant differences between groups A and C,B and C(P<0.05),but there were no significant differences between groups A and B(P>0.05).Conclusion DTI could directly and quantitatively analyze the imaging features of annulus fibrosus tears;The number of nerve fibers were significantly decreased,the corresponding FA value was decreased and the ADC value was increased at the site of intervertebral disc tear compared with the normal,the difference was statistically significant(P<0.05);The appearance of HIZ was a reliable sign of annulus fibrosus tear.

关 键 词：下腰痛 高信号区 磁共振成像 椎间盘弥散张量成像 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]