DTI在颈椎间盘突出症致臂丛神经受累中的应用

Application of DTI in the Involvement of Brachial Plexus in Cervical Disc Herniation

目的探讨DTI对颈椎间盘突出所致臂丛神经受累病变的应用价值。方法方便选择该院2015年10月—2017年12月间臂丛牵拉试验阳性,存在单侧颈椎间盘突出患者(病变组)及健康成人(健康组)各50例,分别行DTI扫描后测量病变组患侧、健侧以及对照组同病变组患侧的臂丛FA值和ADC值,并行臂丛DTT成像。比较两组资料中三者的FA值和ADC值。结果病变组患侧臂丛,健侧及对照组同病变侧平均FA值分别为(0.338±0.027)、(0.405±0.009)及(0.410±0.011),ADC值分别为(1.741±0.091)×10-3mm2/s、(1.297±0.095)×10-3mm2/s及(1.297±0.089)×10-3mm2/s。分别行成组t检验,差异有统计学意义(t=4.13,P<0.05;t=4.52,P<0.05)。通过进一步两两比较,健康对照组和病变组患者同侧对应的臂丛束的平均FA值和ADC值存在差异(P<0.05),病变组患侧臂丛的FA值显著低于健康对照组的,ADC值显著高于健康对照组;病变组患者健侧与患侧对应的臂丛束的平均FA值和ADC值存在差异(P<0.05),病变组患侧臂丛的FA值显著低于健侧,ADC值显著高于健侧;病变组患者健侧与健康对照组同侧臂丛的FA值和ADC值没有显著性变化(P>0.05)。结论臂丛DTI成像,可以显示臂丛神经解剖形态及走行,并可通过量化分析,提供神经根病变的定量数据,更能反映出导致患者临床症状的臂丛神经情况。

Objective To investigate the value of DTI in the diagnosis of brachial plexus involvement in cervical disc herniation. Methods From October 2015 to December 2017,the brachial plexus traction test was positive. There were 50 patients with unilateral cervical disc herniation (disease group) and healthy adults (healthy group). The lesions were measured after DTI scan. The brachial plexus FA value and ADC value of the affected side,the healthy side and the control group were compared with the control group,and the brachial plexus DTT was imaged. The FA and ADC values of the three groups were compared. Results The mean FA values of the lateral brachial plexus,the healthy side and the control group were(0.338±0.027),(0.405±0.009) and(0.410±0.011),respectively. The ADC values were (1.741±0.091)×10^-3mm^2/s and (1.297±0.095)×10^-3 mm^2/s and (1.297±0.089)×10^-3 mm^2/s. The t-test was performed in groups,and the difference was statistically significant (t=4.13,P<0.05;t=4.52,P<0.05). By further comparison,the mean FA value and ADC value of the ipsilateral brachial plexus bundles in the healthy control group and the disease group were different (P<0.05),and the FA value of the lateral brachial plexus in the lesion group was significantly lower than that of the healthy group. In the control group,the ADC value was significantly higher than that in the healthy control group;the mean FA value and ADC value of the brachial plexus bundle corresponding to the affected side and the affected side of the lesion group were different (P<0.05),and the diseased group had the lateral brachial plexus. The FA value was significantly lower than that of the healthy side,and the ADC value was significantly higher than that of the healthy side. There was no significant change in the FA value and ADC value of the ipsilateral brachial plexus between the healthy side and the healthy control group (P>0.05). Conclusion Brachial plexus DTI imaging can show the anatomy and movement of brachial plexus,and quantitative analysis can provide quantitative data of radiculopathy,which can better reflect the brachial plexus that leads to clinical symptoms.