磁共振神经成像技术对骨质疏松性腰椎骨折患者脊神经压迫的诊断价值

Diagnostic value of magnetic resonance neurography for spinal nerve compression in patients with osteoporotic lumbar fracture

目的研究磁共振神经成像(MRN)技术对骨质疏松性腰椎骨折患者脊神经压迫的诊断价值。方法选取2018年1月至2021年12月江苏省淮安市第二人民医院收治的骨质疏松性腰椎骨折患者67例,均行磁共振成像及MRN检查,包括腰椎T1(加权成像)WI矢状位、T2WI矢状位、T2WI轴位、短时间反转恢复(STIR)序列、三维-多回波恢复梯度回波(3D-MERGE)序列。比较STIR、3D-MERGE序列的信噪比(SNR)、对比噪声比(CNR)及脊神经显示评分。以手术结果为“金标准”,分析二者对脊神经压迫的诊断效能。结果3D-MERGE序列的SNR、CNR均大于STIR序列,脊神经显示评分等级优于STIR序列(P<0.05)。STIR序列诊断显示,67例骨质疏松性腰椎骨折患者中发生脊神经压迫扭曲6例,3D-MERGE序列诊断显示为9例,手术结果显示为10例。3D-MERGE序列诊断骨质疏松性腰椎骨折患者脊神经压迫的准确度高于STIR序列(P<0.05),二者灵敏度、特异度比较,差异无统计学意义(P>0.05)。结论MRN对骨质疏松性腰椎骨折患者脊神经压迫扭曲具有较高的诊断价值,能为临床脊神经病变的诊治提供科学合理的影像学依据。

Objective To study the diagnostic value of magnetic resonance neurography(MRN)for spinal nerve compression in patients with osteoporotic lumbar fracture.Methods Sixty-seven patients with osteoporotic lumbar fracture admitted to Huaian Second People’s Hospital,Jiangsu Province from January 2018 to December 2021 were selected.All of them underwent magnetic resonance imaging and MRN examination,included sagittal position of lumbar T1(weighted imaging)WI,sagittal position of T2WI,axial position of T2WI,short time inversion recovery(STIR)sequence,and three dimensional-multiple echo recalled gradient echo(3D-MERGE)sequence.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and spinal nerve display score of STIR and 3D-MERGE sequences were compared.With surgical results as the“gold standard”,the diagnostic efficacy of the two sequences for spinal nerve compression was analyzed.Results The SNR and CNR of 3D-MERGE sequence were higher than those of STIR sequence,and the grade of spinal nerve display score was better than STIR sequence(P<0.05).STIR sequence diagnosis showed six cases of spinal nerve compression and distortion among 67 patients with osteoporotic lumbar fracture,nine cases of 3D-MERGE sequence diagnosis,and ten cases of surgical results.The accuracy of 3D-MERGE sequence in diagnosing spinal nerve compression in patients with osteoporotic lumbar fracture was higher than that of STIR sequence(P<0.05),but there was no significant difference in sensitivity and specificity between the two sequences(P>0.05).Conclusion MRN has a high diagnostic value for spinal nerve compression and distortion in patients with osteoporotic lumbar fracture,and can provide scientific and reasonable imaging basis for the diagnosis and treatment of clinical spinal neuropathy.