颈椎间盘突出相应神经根受压的弥散张量成像评价  

Evaluation of diffusion tensor imaging in cervical spinal nerve root compression

作　　者：朱丽 李杨[2] 杨汉丰[2] 张川[2] 秦俭[1] 修志刚[1] 徐晓雪[2] ZHU Li;LI Yang;YANG Han-feng;ZHANG Chuan;QIN Jian;XIU Zhi-gang;XU Xiao-xue(Department of Radiology,First People’s Hospital of Longquanyi District,Chengdu,610100,China;Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Sichuan,637000,China)

机构地区：[1]成都市龙泉驿区第一人民医院放射科,四川成都610100 [2]川北医学院附属医院放射科,四川南充637000

出　　处：《颈腰痛杂志》2023年第3期405-409,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨MRI弥散张量成像(diffusion tensor imaging,DTI)对颈椎间盘突出(cervical disc herniation,CDH)相应神经根受压的评价价值。方法收集30例CDH患者与30例健康志愿者,利用VAS评分对患者进行疼痛学评分。对患者及健康志愿者进行颈椎间盘常规MRI及DTI检查,定量测量受压神经根的各向异性分数(fractional anisotropy,FA)、表观扩散系数(apparent diffusion coefficient,ADC),并进行神经根神经纤维束示踪成像(fiber tractography,FT)。比较患者受压神经根与健康志愿者神经根的FA值、ADC值差异;根据椎间盘突出层面不同,分节段比较患侧与健侧神经根的FA值、ADC值;分析FA、ADC值与病程和VAS评分的相关性。结果CDH患者的患侧受压神经根较健侧FA值显著减低(患侧vs健侧神经根,C_(5):0.201 vs 0.285,C_(6):0.232 vs 0.301,C_(7):0.228 vs 0.291),ADC值显著升高(患侧vs健侧神经根,C_(5):1.798 vs 1.553,C_(6):1.691 vs 1.537,C_(7):1.779 vs 1.600),P<0.05。FT图显示:健康志愿者双侧神经根走行自然;CDH患者的患侧神经根纤维束明显较健侧稀疏,形态欠规则,部分神经根可见压痕、移位。患侧神经根FA平均值与病程(r=-0.379,P<0.05)及VAS评分(r=-0.363,P<0.05)呈负相关,ADC平均值与VAS评分(r=0.399,P<0.05)呈正相关。结论DTI可用于定量评价CDH相应受压神经根的损伤。Objective To explore the evaluation of diffusion tensor imaging(DTI)in the compression of nerve root of cervical disc herniation(CDH).Methods Totally30 patients with cervical disc herniation and 30 healthy volunteers were selected in this study.Visual analogue scale(VAS)was used for pain assessment.All of the subjects accepted routine MRI and DTI examinations of cervical spine.The FA and ADC values of the compressed nerve roots were measured quantitatively,and fiber tractography(FT)imaging of cervical nerves was performed.The difference in FA and ADC value of nerve root between patients and healthy volunteers were compared.According to the different layers of disc herniation,the FA and ADC values of nerve roots in affected and healthy sides were compared segmentally.The correlation between FA and ADC values and course of disease and VAS score was analyzed.Results In CDH patients,the FA values of the compressed nerve roots on the affected side were significantly lower than those on the healthy side(C_(5):0.201 vs 0.285,C_(6):0.232 vs 0.301,C_(7):0.228 vs 0.291),and the ADC values were significantly higher(C_(5):1.798 vs 1.553,C_(6):1.691 vs 1.537,C_(7):1.779 vs 1.600)(P<0.05).FT images showed that the nerve root fascicles of the affected side were significantly sparser than those of the healthy side,and some nerve roots showed indentation and displacement.The FA value of affected side was negatively correlated with course(month)(r=-0.379,P<0.05)and VAS score(r=-0.363,P<0.05).There was positive correlation between the ADC value and VAS score(r=0.399,P<0.05).Conclusion DTI can be used to quantitatively evaluate the injury of the corresponding compressed nerve roots caused by CDH.

关 键 词：磁共振成像 弥散张量成像 颈椎间盘突出 神经根受压 

分 类 号：R681.5[医药卫生—骨科学]