3.0 T磁共振扩散张量成像在诊断椎间盘源性腰痛中的应用  

Using 3.0-T Diffusion Tensor Imaging to Diagnose Discogenic Low Back Pain

作　　者：田帅 宁春芳 韩嵩博[1] 田春艳[1] 张立华[1] 郎宁[1] 袁慧书[1] TIAN Shuai;NING Chunfang;HAN Songbo(Department of Radiology,Peking University Third Hospital,Beijing 100191,P.R.China)

机构地区：[1]北京大学第三医院放射科,100191

出　　处：《临床放射学杂志》2024年第5期806-810,共5页Journal of Clinical Radiology

摘　　要：目的 利用磁共振扩散张量成像(DTI)观察椎间盘源性腰痛患者纤维环的形态和完整性,通过测量表观扩散系数(ADC)和各向异性分数(FA)对椎间盘源性腰痛患者纤维环进行定量分析。方法 30例反复下腰痛患者及24名无症状的健康志愿者被纳入本研究。在轴位DTI中的椎间盘纤维环后缘勾画感兴趣区,测量并比较ADC、FAλ1、λ2及λ3值。结果 下腰痛组受试者[(58±6)岁,16例女性]和健康对照组受试者[(54±6)岁,12名女性]中,下腰痛组ADC值高于对照组(下腰痛组:9.84±4.01;健康对照组:6.10±3.17;P<0.001),而FA值低于对照组(下腰痛组:0.231±0.150;健康对照组:0.341±0.201;P<0.007)。结论 3.0 T磁共振DTI对椎间盘源性腰痛的临床诊断和责任节段的术前定位具有指导意义,可以为椎间盘源性腰痛的手术干预提供客观指标。Objective This study examined annulus fibrosus morphology and integrity by measuring the apparent diffusion coefficient(ADC) and fractional anisotropy(FA) using DTI and by discography. Methods This retrospective case–control study enrolled 30 continuous patients with recurrent low back pain(LBP) confirmed by discography and 24 healthy control(HC) volunteers.The ADC and FA values at the posterior margin of the annulus fibrosus were measured using a conventional lumbar MR sequence and axial DTI of the L_3-S_1 levels(3.0-T).The intervertebral discogenic low back pain segment was identified by discography. The ADC and FA values were measured at the posterior margin of the annulus fibrosus of the segment in the experimental group and at the L_3-S_1 level in the control group. Differences in ADC,FA,λ1,λ2 and λ3 values were compared between the two groups. Results Thirty participants(58 ± 6 years, 16 women) were in the LBP group(case),twenty-four(54±6 years, 12 women) were in the HC group(control).No significant differences were found in demographic parameters or the areas of region of interest(ROI) measured manually between the two groups. The ADC value of ROI in the experimental group was higher than that in the control group(LBP:9.84 ± 4.01;HC:6.10 ± 3.17;P<0.001),while the FA value was lower than that in the control group(LBP:0.231 ± 0.150;HC:0.341 ± 0.201;P<0.007). Conclusion 3.0-T magnetic resonance DTI was useful in the clinical assessment of discogenic low back pain.

关 键 词：扩散张量成像 椎间盘源性腰痛 纤维环 椎间盘造影 

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]