急性腰椎间盘突出所致神经根损伤评价中DTI的临床应用价值

Clinical application and feasibility study of DTI in the evaluation of nerve root injury caused by acute lumbar disc herniation

目的探讨急性腰椎间盘突出所致神经根损伤评价中扩散张量成像(diffusion tensor imaging,DTI)的临床应用价值。材料与方法选取2017年5月至2019年5月我院收治的急性腰椎间盘突出患者40例,并选取同期参加研究的健康体检者40例,对其进行磁共振DTI检查,分析DTI在急性腰椎间盘突出症所致神经根损伤评价中的应用价值。结果健康对照组各向异性分数(fractional anisotropy,FA)值以及ADC值左右侧无明显差异(P>0.05),且同侧近、中、远段FA值及ADC值无差异(P>0.05)。单侧急性腰椎间盘突出患者患侧近、中、远段FA值均低于健侧,ADC值高于健侧(P<0.05),且患侧近段FA值高于中段以及远段,ADC值低于中段及远段(P<0.05),中段FA值高于远段,ADC值低于远段(P<0.05);健侧近、中、远段FA值、ADC值无明显差异(P>0.05)。结论采用磁共振DTI检查可以对急性腰椎间盘突出症患者神经根损伤情况进行定量分析,为临床提供精准的影像数据,具有重要应用价值。

Objective:To explore the clinical application and feasibility of diffusion tensor imaging(DTI)in the evaluation of nerve root injury caused by acute lumbar disc herniation.Materials and Methods:40 patients with acute lumbar disc herniation treated in our hospital from May 2017 to May 2019 and 40 healthy subjects who took part in the study in the same period were examined by magnetic resonance DTI,and the application value of DTI in the evaluation of nerve injury caused by acute lumbar disc herniation was analyzed.Results:There are no significant difference in fractional anisotropy(FA)value and ADC value between the left and right sides of the healthy control group(P>0.05),and the FA value and ADC value in proximal,middle and distal of the ipsilateral side also have no difference(P>0.05).In patients with unilateral acute lumbar disc herniation,the FA values of the proximal,middle and distal side are lower than those of the healthy side,but the ADC value of the affected side was higher than that of the healthy side(P<0.05),and the FA value of the proximal side is higher than that of the middle and distal side,and that of the proximal ADC value is lower than that of the middle and distal side(P<0.05).The FA value of the middle side is higher than that of the distal side and the ADC value of the middle is lower than that of the distal(P<0.05).There is no significant difference in FA and ADC values among the proximal,middle and distal side of the healthy one.Conclusions:Magnetic resonance DTI can be used to quantitatively analyze the nerve injury in patients with acute lumbar disc herniation,and the FA value decreases and the ADC value increases in patients with acute lumbar disc herniation.