高场MR成像对梨状肌出口综合征诊断的研究

High-field MRI in the Diagnosis of Piriformis Syndrome

目的:探讨MRI对梨状肌出口综合征的诊断价值。方法:46例临床诊断梨状肌出口综合征患者,绝大多数临床表现为单侧臀部或大腿后部疼痛,均行坐骨神经梨状肌段MRI平扫和增强扫描,观察并分析46例PS患者MRI常规序列表现及信号特点;测量并比较PS组(36例)与对照组(30例)梨状肌的厚度(mm)、面积(mm^(2))值是否具有统计学意义。结果:36例(36/46)梨状肌较对侧肥厚,部分患者梨状肌肌间可见片状长T2信号影,伴或不伴有筋膜及肌腱呈炎性改变,周边肌间可见积液;3例(3/46)表现梨状肌较对侧呈萎缩改变,与邻近坐骨神经脂肪间隙增宽,肌纤维变细,或邻近组织脂肪化等;PS组患侧梨状肌厚度(23.42±2.68mm)、面积(137.35±19.23mm;)明显大于健侧,比较差异具有统计学意义(P<0.05)。结论:MRI常规序列及梨状肌形态学定量分析对PS诊断有意义。

Objective:To investigate the diagnostic value of MRI for piriformis syndrome.Methods:There were 46 clinical patients who were diagnosed with piriformis syndrome.Clinical presentations of most of them were unilateral hemi-pygalgia or posterior thigh pain,and we carried out MRI and contrast scan of piriformis musle of bone nerve.Thereby,we observed and analyzed their MRI routine sequence and signal characteristics,then measured and compared the thickness and area of piriformis musle of them(36 patients)with control groups(30 patients)to confirm if data were meaningful in statistics.Results:Piriformis musle in 36 cases(36/46)were thicker than contralateral musle,the intermuscular length in some patients had signal shadow of flakiness with T2 WI,with or without inflammatory changes in fascia and tendon,and effusion could be seen between the peripheral muscles.There were 3 cases(3/46)which showed atrophy in piriformis musle compared with contralateral musle,along with wider gap between sciatica nerves fat,thinner muscle fibers,fatty tissues near piriformis musle and so on;the thickness of piriformis(23.42±2.68 mm)and area(137.35±19.23 mm^(2))were significantly larger than tendon side and comparison of differences were meaningful in statistics(P<0.05).Conclusion:MRI routine sequence and the quantitative analysis of piriformis musle are significant in the diagnosis of PS.