腰椎MRI评估马尾神经前根横截面积在脊髓性肌萎缩Ⅱ型和Ⅲ型的应用价值  

Application value of lumbar MRI in the evaluation of cross-sectional area of the anterior cauda equina nerve roots in type Ⅱ and Ⅲ spinal muscular atrophy

作　　者：陈希文 吴慧莹 鹿连伟 陈臻 张明杰 曹亚先 隋艺 CHEN Xi-wen;WU Hui-ying;Lu Lian-wei(Department of Radiology,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou 510623,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心放射科,广州510623

出　　处：《放射学实践》2024年第7期942-946,共5页Radiologic Practice

基　　金：广东省医学科学基金技术研究基金(A20211261);广州市卫生健康科技一般引导项目(20221A011024)。

摘　　要：目的:探讨腰椎MRI评估马尾神经前根横截面积在脊髓性肌萎缩(SMA)Ⅱ型和Ⅲ型的应用价值。方法:根据发病年龄及能达到的最大运动里程碑,将26例基因确诊的SMA儿童分为SMAⅡ型组16例和SMAⅢ型组10例,以双下肢肌力评定标准,将其分为轻度组13例和中重度组13例,同时收集性别、年龄匹配的26例健康儿童作为对照组(NC)。以腰椎MRI正中矢状面T_(2)WI快速自旋回波序列脊髓圆锥下方10 mm的横轴面图像作为测量平面,分别测量各组左、右马尾神经前根的最大横截面积(MCA),进行组内与组间比较。结合双下肢肌力组别,进行左、右马尾神经前根MCA比较分析,同时评价两者相关性。结果:SMAⅡ型组[左侧(0.942±0.141)mm^(2)vs.(1.313±0.217)mm^(2),t=-5.729,P<0.01;右侧(0.907±0.185)mm^(2)vs.(1.309±0.194)mm^(2),t=-5.984,P<0.01]和Ⅲ型组[左侧(1.047±0.150)mm^(2)vs.(1.588±0.255)mm^(2),t=-5.779,P<0.01;右侧(1.065±0.148)mm^(2)vs.(1.603±0.253)mm^(2),t=-5.799,P<0.01]儿童马尾神经前根的MCA均较其性别、年龄匹配的NC组纤细。不同肌力组别SMA儿童同侧马尾神经前根MCA之间差异具有统计学意义(P均<0.01)。SMA儿童左、右马尾神经前根MCA与双下肢肌力之间存在较强正相关(左侧r=0.763,右侧r=0.813)。结论:马尾神经前根纤细是SMA儿童特征性影像学标志。腰椎MRI可定量测量SMAⅡ型和Ⅲ型儿童马尾神经前根横截面积,MCA与双下肢肌力呈正相关。Objective:To investigate the application value of lumbar MRI in evaluating the cross-sectional area of anterior cauda equina nerve roots in type Ⅱ and Ⅲ spinal muscular atrophy(SMA).Methods:According to the age of onset and the maximum exercise milestone that can be achieved,26 children with genetically confirmed SMA were divided into the SMA Ⅱ group(n=16) and the SMA Ⅲ group(n=10).According to the evaluation criteria of muscle strength of both lower limbs,they were divided into mild group(n=13) and moderate to severe group(n=13).At the same time,26 healthy children matched with sex and age were collected as a normal control(NC) group.The maximum cross-sectional area(MCA) of the left and right anterior cauda equina nerve roots were measured at 10mm below the conus medullaris on the median sagittal T_(2WI) sequence of lumbar MRI,and the results were compared and analyzed between groups.Combined with the muscle strength group,the MCA of the left and right anterior cauda equina nerve roots were compared and analyzed,and the correlation between them was evaluated.Results:The anterior cauda equina nerve roots in the sex and age-matched SMA type Ⅱ and Ⅲ group were more slender than those in the NC group [SMA Ⅱ group:left(0.942±0.141)mm^(2) vs.(1.313±0.217)mm^(2),t=-5.729,P<0.01;right(0.907±0.185)mm^(2) vs.(1.309±0.194)mm^(2),t=-5.984,P<0.01.SMA Ⅲ group:left(1.047±0.150)mm^(2) vs.(1.588±0.255)mm^(2),t=-5.779,P<0.01;right(1.065±0.148)mm^(2) vs.(1.603±0.253)mm^(2),t=-5.799,P<0.01].There were significant differences in MCA of ipsilateral anterior cauda equina nerve roots among different muscle strength groups of SMA children(P<0.01).There was a strong positive correlation between the MCA of the left and right anterior cauda equina nerve roots and the muscle strength of both lower limbs in children with SMA(left r=0.763,right r=0.813).Conclusion:The slender anterior cauda equina nerve roots are a characteristic imaging sign in children with SMA.Lumbar MRI can be used to evaluate the cross-sectional a

关 键 词：磁共振成像 脊髓性肌萎缩 马尾神经根 儿童 

分 类 号：R445.2[医药卫生—影像医学与核医学] R746.4[医药卫生—诊断学]