MRI弥散张量成像对腰骶神经根受压的诊断分析

Analysis on MRI diffusion tensor imaging in diagnosis of lumbosacral nerve root compression

目的探究腰骶神经根受压患者行常规MRI检查及弥散张量成像检查的效果及价值。方法选取2017年3月~2018年11月我院收治的40例腰椎间盘突出症所致慢性腰背疼痛合并单侧下肢放射性疼痛患者为观察组研究对象,选取同期在我院进行常规检查受检者共40例为对照组研究对象。两组受检者均行磁共振弥散张量成像及常规MRI扫描,对观察组患者健侧、患侧神经根各项异性分数(FA)值、表观扩散系数(ADC)值。以及对照组受检者双侧FA值、ADC值进行测量和统计学比较,对感兴趣区进行设置并通过后期处理进行受检者腰骶部位神经根纤维束成像。结果对照组受检者双侧FA值、ADC值数据经比较差异无统计学意义(P> 0.05),观察组患者患侧FA值相比健侧FA值数据明显更低,而患侧ADC值相比健侧ADC值则明显更高,差异有统计学意义(P <0.05)。纤维束成像结果显示两组受检者神经根走行情况清晰,能够准确分析患者腰骶神经根受压情况。观察组患者患侧神经根与其症状侧相同。常规MRI扫描及症状间缺乏相关性。结论磁共振弥散张量成像结果相比于常规MRI扫描结果对患者临床症状以及腰骶神经根受压情况的反映效果更清晰和客观,对患者病情诊断效果、预后评估、治疗方案的制定均提供了有效的依据,因此该种检查方法更值得在临床中进行大力推广。

Objective To explore the effect and value of routine MRI and diffusion tensor imaging in patients with lumbosacral nerve root compression. Methods 40 patients with chronic low back pain and unilateral lower extremity radiation pain caused by lumbar disc herniation who were admitted to our hospital from March 2017 to November2018 were selected as research objects in the observation group.40 subjects who underwent routine examinations in our hospital were selected as research objects in the control group.Both groups underwent MRI diffusion tensor imaging and conventional MRI scan.Fractional anisotropy(FA)values and apparent diffusion coefficient(ADC)values of healthy and affected nerve root of patients in the observation group and bilateral FA values and ADC values of subjects in the control group were measured and statistically compared.The region of interest was set and the nerve root fiber bundle imaging of the lumbosacral region of the subjects was performed by post-processing. Results There was no significant statistically difference in the bilateral FA and ADC values of objects in the control group(P > 0.05).The FA value of the affected nerve root was significantly lower than that of the healthy side,while ADC value of affected nerve root was significantly higher than that of the healthy side.The difference was statistically significant(P < 0.05).The results of fiber bundle imaging showed that the nerve roots of the two groups were clear and could accurately analyze the compression of the lumbosacral nerve roots.In the observation group,the affected nerve root was the same as the affected side.There was a lack of correlation between routine MRI scans and symptoms. Conclusion Compared with conventional MRI scan,results of MRI diffusion tensor imaging can more clearly and objectively reflect the clinical symptoms and lumbosacral nerve root compression.It provides an effective basis for the diagnosis effect,prognosis evaluation and treatment plan formulation of patients.Therefore,this kind of examination method is worthy of wide promotion in clinical practice.