腰椎管狭窄与马尾神经冗余关系的MRI形态学定量分析  

The relationship between lumbar spinal canal stenosis and redundant nerve roots in morphological quantitative analysis of MRI

作　　者：刘英[1] 郭家川[2] 李旭雪 陈君蓉[1] LIU Ying;GUO Jiachuan;LI Xuxue;CHEN Junrong(Department of Radiology,Sichuan Orthopaedic Hospital,Chengdu 610041,China;Department of Radiology,Sichuan Province People’s Hospital,Chengdu 610072,China)

机构地区：[1]四川省骨科医院放射科,四川成都610041 [2]四川省人民医院放射科,四川成都610072

出　　处：《医学影像学杂志》2024年第9期123-126,共4页Journal of Medical Imaging

基　　金：四川省医学会骨科(尚安通)专项科研课题(编号:2021SAT18)。

摘　　要：目的探讨应用MRI分析腰椎管狭窄与马尾神经冗余(redundant nerve roots,RNRs)之间的关系。方法选取我院临床诊断为腰椎管狭窄患者155例的MRI资料。根据矢状位T2WI马尾神经形态将患者分为RNRs阳性组和RNRs阴性组,测量并记录狭窄节段椎管硬膜囊横截面积及硬膜囊前后径,统计分析RNRs阳性组和RNRs阴性组之间硬膜囊横截面积、硬膜囊前后径、椎管狭窄程度的差异,进一步分析RNAs阳性组椎管不同狭窄程度间马尾神经冗余长度的差异。结果腰椎管狭窄患者中马尾神经冗余的发生率为34.2%。RNRs阳性组平均年龄大于RNRs阴性组,腰椎管最窄层面平均硬膜囊横截面积及硬膜囊前后径均小于RNRs阴性组,椎管狭窄程度大于RNRs阴性组,差异均有统计学意义(P均<0.05)。RNRs阳性组女性发生率较男性稍高(56.6%vs 43.4%),但差异无统计学意义(P>0.05);RNRs阳性组椎管不同狭窄程度间马尾神经冗余长度差异具有统计学意义(P<0.05)。结论RNRs是一种特殊的影像学表现,常见于较严重的腰椎管狭窄患者,能够被MRI清晰地展现,为腰椎管狭窄症的明确诊断提供了重要的依据。Objective To analyze the relationship between lumbar spinal canal stenosis and redundant nerve roots(RNRs)using MRI.Methods The MRI data of 155 patients were collected with lumbar spinal stenosis who were clinically diagnosed in our hospital from February 2022 to August 2022.The patients were divided into RNRs positive group and RNRs negative group according to the shape of cauda equina nerve on sagittal T2WI images.We measured and recorded the area and the anterior posterior diameter of the dural sac,and statistically analyzed the differences between RNRs positive group and RNRs negative group in the dural sac area,the dural sac anterior posterior diameter and the degree of spinal stenosis.We further analyzed the difference in the redundant length of cauda equina nerve between different degrees of spinal stenosis in the RNAs positive group.Re⁃sults The incidence of cauda equina redundancy was 34.2%in patients with lumbar spinal stenosis.The average age of the RNRs positive group was greater than that of the RNRs negative group,the average dural sac area and the anterior posterior diameter at the narrowest level of the lumbar spinal canal were smaller than those of the RNRs negative group,and the degree of spinal stenosis was greater than that of the RNRs negative group(P<0.05).The incidence of women in RNRs positive group was slightly higher than that of men(56.6%vs 43.4%),but the difference was not statistically significant;The redundancy length of cauda equina nerve in RNRs positive group was statistically significant(P<0.05).Conclusions RNRs is a special imaging manifestation,which provides an important basis for the clear diagnosis of lumbar spinal stenosis.It is commonly seen in patients with severe lumbar spinal stenosis and can be clearly demonstrated by MRI.

关 键 词：腰椎管狭窄 硬膜囊横截面积 马尾神经冗余 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]