高分辨率MRI对腰椎间孔狭窄神经根受压诊断价值  

Diagnostic value of high-resolution MRI for nerve root compression in lumbar intervertebral foramen stenosis

作　　者：贺雨欣 吴蓉 耿立刚 何仕丽 张高峰 HE Yuxin;WU Rong;GENG Ligang;HE Shili;ZHANG Gaofeng(Department of Medical Imaging,the Second Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou Province 563000,China)

机构地区：[1]遵义医科大学第二附属医院医学影像科,贵州遵义563000

出　　处：《实用放射学杂志》2024年第5期781-784,共4页Journal of Practical Radiology

摘　　要：目的探讨高分辨率MRI对腰椎间孔狭窄原因、部位及神经根受压程度与临床症状的相关性价值。方法坐骨神经痛患者治疗前行腰椎常规MRI检查,对可疑L4/L5、L5/S1椎间孔狭窄患者行MRI薄层(1mm)椎间盘轴位扫描,对比分析常规MRI及高分辨率MRI对椎间孔狭窄部位、病因及Elisabeth分型价值;在高分辨率MRI后处理图像上测量椎间孔形态学指标、神经根长短径,并分析其与临床症状视觉模拟量表(VAS)评分的相关性。结果61例患者椎间孔狭窄神经根受压经手术或保守治疗有效确诊,常规MRI对椎间孔狭窄原因诊断率75.4%,高分辨率MRI并后处理诊断率91.8%。腰椎间孔狭窄程度Elisabeth分型与临床症状呈正相关,神经根短径、神经根周围脂肪间隙面积与VAS评分呈负相关。结论高分辨率MRI对椎间孔狭窄神经根受压诊断明显优于常规MRI,可视化显示神经根受压部位、原因及程度,能更好地指导临床开展精准微创手术。Objective To explore the correlation value of high-resolution MRI on the cause,location and degree of nerve root compression and clinical symptoms of lumbar intervertebral foramen stenosis.Methods Patients with sciatic neuralgia underwent conventional MRI examination of the lumbar spine before treatment.MRI thin layer(1 mm)intervertebral disc axial scan was performed on patients with suspected I4/L5 and L5/S1 intervertebral foramen stenosis,and the value of conventional MRI and high-resolution MRI on intervertebral foramen stenosis location,etiology and Elisabeth typing was compared and analyzed.Intervertebral foramen morphometric indicators,nerve root length and short diameter were measured on high-resolution MRI post-processed images and their correlation with visual analogue scale(VAS)scores of clinical symptoms was analyzed.Results Sixty-one patients were effectively diagnosed with intervertebral foramen stenosis and nerve root compression after surgery or conservative treatment.The diagnosis rate of conventional MRI for the cause of intervertebral foramen stenosis was 75.4%,and the diagnosis rate of high-resolution MRI post-processed was 91.8%.The Elisabeth typing of lumbar intervertebral foramen stenosis was positively correlated with clinical symptoms,while the nerve root short diameter and peri-nerve fat space area were negatively correlated with VAS score.Conclusion High-resolution MRI is significantly better than conventional MRI for the diagnosis of nerve root compression in intervertebral foramen stenosis,It visually shows the location,cause and degree of nerve root compression,which can better guide the clinical and accurate minimally invasivesurgery.

关 键 词：高分辨率磁共振成像 椎间孔 神经根 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.5[医药卫生—诊断学]