DTI定位责任椎间盘在腰椎间盘等离子射频治疗中的运用  

Application of DTI to locate the responsible intervertebral disc in lumbar spine plasma radiofrequency treatment

作　　者：全杰 康新国[1] 徐睿[1] 邹晋峰[1] Quan Jie;Kang Xinguo;Xu Rui;Zou Jinfeng(Department of Pain,Guizhou Provincial People’s Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院疼痛科,贵州贵阳550002

出　　处：《贵州医药》2024年第9期1366-1369,I0001,共5页Guizhou Medical Journal

摘　　要：目的评估3.0T磁共振(MR)弥散张量成像(DTI)在多节段腰椎间盘突出症患者的诊断及等离子射频治疗中的价值。方法多节段腰椎间盘突出症行腰椎等离子射频治疗患者60例,随机分成两组,A组为神经阻滞定位责任椎间盘组,B组为DTI定位责任椎间盘。比较患者压缩和非压缩神经根之间的分数各向异性(FA)和表观扩散系数(ADC)的差异,然后比较A组与B组患者等离子射频治疗前,治疗后3 d、7 d、1个月采用视觉模拟评分法(VAS)评分法评估疼痛情况。治疗后1个月MacNab评分法判断疗效。结果责任节段FA值显著低于同一水平非责任节段FA值,责任节段ADC值显著高于同一水平非责任节段ADC值,两者均具有统计学意义。A组术后和B组术后较术前比都有治疗效果。B组术后3 d、7 d、1个月疗效较A组更优。MacNab评分无明显统计学差异(P>0.05)。结论通过3.0T磁共振DTI可准确定位受压的腰骶神经根,对临床准确诊断和术前定位及治疗具有指导意义。Objective To evaluate the value of 3.0T magnetic resonance(MR)diffusion tensor imaging(DTI)in the diagnosis and plasma radiofrequency treatment of patients with multi-level lumbar disc herniation.Methods 60 patients with multi-level lumbar disc herniation who underwent lumbar plasma radiofrequency treatment were randomly divided into 2 groups.Group A was the nerve block group responsible for positioning the intervertebral disc.Group B is for DTI to locate the responsible intervertebral disc.Compare the differences in fractional anisotropy(FA)and apparent diffusion coefficient(ADC)between patients compressed and non-compressed nerve roots,and then compare patients in group A and group B before plasma radiofrequency treatment,3 days,7 days,and 1 month after treatment.Pain was assessed using the visual analogue scale(VAS)score in 1 month.The efficacy was judged by MacNab score one month after treatment.Results The FA value of the responsible segment was significantly lower than the FA value of the non-responsible segment at the same level,and the ADC value of the responsible segment was significantly higher than the ADC value of the non-responsible segment at the same level,both there were statistically significant differences.Both group A and group B had better therapeutic effect after surgery than before surgery.The curative effect of group B at 3 days,7 days,and 1 month after surgery was better than that of group A.There were no significant statistical differences in MacNab scores.Conclusion The compressed lumbosacral nerve root can be accurately located through 3.0T magnetic resonance DTI,which has guiding significance for accurate clinical diagnosis and preoperative positioning and treatment.

关 键 词：磁共振成像 扩散张量成像 腰椎间盘突出症 视觉模拟评分 等离子射频消融术 

分 类 号：R687.3[医药卫生—骨科学]