DTI对保守治疗腰椎间盘突出受压神经根损伤的诊断价值

Evaluation of conservative treated nerve injury compressed by lumbar disc herniation using DTI

目的:利用磁共振弥散张量成像(DTI)技术测量正常腰神经、椎间盘突出受压腰神经的FA值及ADC值,探讨腰神经根受压损伤的定量评估方法。方法:选择健康志愿者50例作为对照组,51例椎间盘突出症患者作为实验组。测量正常腰神经根及受压腰神经根的FA值及ADC值。比较对照组与实验组FA值及ADC值。保守治疗前后FA值及ADC值。对照组与保守治疗后的FA值及ADC值。所测数据使用SPSS17.0软件进行数据分析,若P<0.05认为差异有统计学意义。结果:对照组与实验组:FA值比较,t=12.172,P=0.000。ADC值比较,t=-5.673,P=0.000。P<0.05,认为两组数据有明显差别。保守治疗前后:FA值比较,t=-10.221,P=0.000,ADC值比较,t=4.671,P=0.000。两组数据P<0.05,有明显差别。对照组与保守治疗好转后:FA值比较,t=1.344,P=0.182;ADC值比较,t=-1.532,P=0.129。P>0.05,认为两组数据无差异。结论:磁共振DTI成像测量FA值及ADC值与椎间盘突出压迫神经根的临床表现是一致的,可以用于定量评估腰神经的受压损伤。

Objective: To observe the fractional anisotropy (FA) value and apparent dispersion coefficient (ADC) value of normal lumbar nerves,lumbar nerves compressed by disc herniation before and after conservative treatment using magnetic resonance diffusion tensor imaging (DTI) technique,and to explore the quantitative evaluation method of lumbar nerve root compression injury. Methods: Fifty healthy volunteers were selected as the control group and fifty-one patients with disc herniation as the experimental group.The FA and ADC value of normal lumbar nerve root and compressed lumbar nerve root were measured in each group.The following parameters were compared:①FA and ADC values of the control group and the experimental group;②FA and ADC values before and after conservative treatment;and,③FA and ADC values of the control group and conservative group.The measured data were analyzed using SPSS 17.0 software.Statistically significant was considered for P values less than 0.05. Results:①Control group and experimental group:the t value was 12.172 and P value was 0.000 for comparison of FA value.In comparison of ADC,the t value was -5.673 and pvalue was 0.000.There are significant differences of two groups.②FA and ADC value before and after conservative treatment:comparison of the FA value showed that the t value was -10.221 and the P value was 0.000;the t value was 4.671 and P value was 0.000 in the comparison of ADC value.③FA and ADC value of the control group and conservative group:comparison of the FA value showed that the t value was 1.344 and the P value was 0.182;the t value was -1.532 and P value was 0.129 in the comparison of ADC value.There was no difference between two groups. Conclusion: The FA and ADC values of compressed nerve roots measured by magnetic resonance DTI imaging can be used to assess the injury of lumbar nerve compression quantitatively.