DTI技术对行椎经板间内镜椎间盘切除术治疗腰椎间盘突出症患者术前、术后神经束变化的评价

Value of DTI in evaluating the changes of nerve tract before and after endoscopic discectomy for lumbar disc herniation

目的磁共振扩散张量成像(DTI)技术对行椎经板间内镜椎间盘切除术治疗腰椎间盘突出症患者术前、术后神经束变化的评价价值。方法选取2016年1月-2018年1月我院收治的行椎经板间内镜椎间盘切除术治疗腰椎间盘突出症患者80例,所有受检对象在行椎经板间内镜椎间盘切除术前、术后6个月均行常规MRI、DTI检查,并运用神经纤维束示踪成像测定FA值、ADC值。结果腰椎间盘突出症组椎经板间内镜椎间盘切除术前受压腰骶神经FA值低于正常侧,ADC值高于正常侧,具有统计学差异(P<0.05)。腰椎间盘突出症组椎经板间内镜椎间盘切除术后受压侧腰骶神经FA值、ADC值与正常侧相比,无统计学差异(P>0.05)。腰椎间盘突出症患者椎经板间内镜椎间盘切除术后受压侧腰骶神经FA值高于术前,ADC值低于术前,具有统计学差异(P<0.05)。结论 DTI技术可有效反映出行椎经板间内镜椎间盘切除术治疗腰椎间盘突出症患者术前、术后神经束变化,评价价值较高,可用于临床腰椎间盘突出症患者手术治疗效果评价。

Objective The value of diffusion tensor imaging(DTI)in evaluating the changes of nerve tract before and after endoscopic discectomy for lumbar disc herniation.Methods Eighty patients with lumbar disc herniation treated by translaminar endoscopic discectomy in our hospital from January 2016 to January 2018 were selected.All subjects underwent routine MRI and DTI examinations before and 6 months after translaminar endoscopic discectomy.FA and ADC values were measured by nerve fiber tract tracer imaging.Results In the lumbar disc herniation group,the FA value of the compressed lumbosacral nerve before endoscopic discectomy was lower than that of the normal side,and the ADC value was higher than that of the normal side(P<0.05).There was no significant difference in FA and ADC values between the compressed side and the normal side(P>0.05)in the lumbar disc herniation group after endoscopic discectomy.In patients with lumbar disc herniation,the FA value of compression side of lumbosacral nerve after endoscopic discectomy was higher than that before operation,and the ADC value was lower than that before operation,with statistical difference(P<0.05).Conclusion DTI technology can effectively reflect the changes of nerve tracts before and after endoscopic discectomy for lumbar intervertebral disc herniation.It has a high evaluation value and can be used to evaluate the therapeutic effect of surgical treatment for patients with lumbar intervertebral disc herniation.