超声和MRI诊断梨状肌综合征的价值研究

Value of Ultrasound and MRI in Diagnosising Piriformis Syndrome

目的探究超声及磁共振成像(MRI)对梨状肌综合征的诊断价值。方法对2016年6月至2019年6月40例明确单侧梨状肌综合征患者(病例组)与40例健康志愿者(对照组)均行超声检查及MRI检查,观察病例组与对照组梨状肌及坐骨神经影像学表现,比较病例组与对照组超声下双侧梨状肌厚度差,MRI下不同序列患侧与对侧坐骨神经、肌肉信号强度比(SIR),绘制ROC曲线分析超声及MRI定量指标对梨状肌综合征的诊断价值。结果病例组超声检查下患侧梨状肌厚度显著高于对侧(P<0.05),双侧梨状肌厚度差值显著高于对照组(P<0.05);病例组MRI检查下T2WI、SPAIR序列患侧SIR均显著高于对侧(P<0.05);用双侧梨状肌厚度差值诊断梨状肌综合征的ROC曲线下面积为0.787,用T2WI序列、SPAIR序列SIR诊断梨状肌综合征的ROC曲线下面积分别为0.865、0.845。结论超声与MRI检查均能清楚显示梨状肌、坐骨神经,且无论是定性分析还是定量测量,均可为临床诊断梨状肌综合征提供更多信息。

Objective To investigate the diagnostic value of ultrasound and magnetic resonance imaging (MRI) on piriformis syndrome.Methods From June 2016 to June 2019,40 patients with definite unilateral piriformis syndrome (the case group) and 40 healthy volunteers (the control group) underwent ultrasound and MRI.The imaging findings of piriformis and sciatic nerve were observed in the case group and the control group.The thickness difference of bilateral piriformisunder ultrasound and ratio of sciatic nerve and muscle signal intensity (SIR) of affected and contralateral sides of different sequences under MRI were compared between the case group and the control group.The ROC curve was drawn to analyze the diagnostic value of quantitative indicators of ultrasound andMRI on piriformis syndrome.Results The piriformis thickness of affected side in the case group was significantly higher than that of contralateral side (P<0.05),and the difference of bilateral piriformis thickness was significantly higher than that in the control group (P<0.05).The SIR values of affected side of T2WI and SPAIR sequences under MRI in the case group were significantly higher than those of contralateral side (P<0.05).The area under the ROC curve of difference of bilateral piriformis thickness was 0.787 in diagnosing piriformis syndrome.The values of area under the ROC curve of SIR of T2WI sequence and SPAIR sequence were 0.865 and 0.845 respectively in diagnosing piriformis syndrome.Conclusion Ultrasound and MRI can clearly show the piriformis and sciatic nerve,and whether it is qualitative analysis or quantitative measurement,they can provide more information for clinical diagnosis of piriformis syndrome.