磁共振弥散张量成像在诊断颈髓损伤及评估预后中的研究

Value of Diffusion Tensor Imaging in the Diagnosis and Prognosis Evaluation of Cervical Spinal Cord Injury

目的探讨磁共振弥散张量成像(DTI)在诊断颈髓损伤及预后评估中的应用价值。方法选取2020年1月至2022年3月收治的38例颈髓损伤患者作为研究组,同期招募性别、年龄相匹配的健康体检者38例作为对照组,两组均行常规MRI和DTI检查,分析二者在颈髓损伤诊断和预后评估中的应用价值。结果研究组治疗前病灶部位ADC值高于对照组和研究.组治疗后,.FA值低于.对照组和研究组治疗后(F=21619;F=33379,P<005);.研究组治疗.后ASIA感觉.、运动评分高于治疗前(t=4717;t=2637,P<005);A~B级组ADC值低于C~D级组,.FA值、AS.IA上肢感.觉和运动评.分高于C~.D级组(t=2443;t=5294;t=5337;t=5540,P<005);颈髓损伤患者FA.值与ASIA.感觉评分、.ASIA运动评分呈正相关(r=0423;r=0475,P<005);改善组病灶.部位ADC.值高于未改.善组,FA值低于未改善组(t=3542;t=3620,P<005).;ROC曲线分析.显示,ADC、.FA联合预.测的AUC为.0911高于.ADC的0790、FA的0749(Z=1993;Z=2182,P<005)。结论DTI可早期显示颈髓的损伤,可用于预后评估。

Objective To explore the application value of diffusion tensor imaging(DTI)in the diagnosis and prognosis evaluation of cervical spinal cord injury(SCI).Methods A total of 38 patients with cervical SCI were enrolled as study group between January 2020 and March 2022,while 38 healthy controls with matched gender and age during the same period were enrolled as control group.Both groups underwent routine MRI and DTI examinations.And their application value in the diagnosis and prognosis evaluation of cervical SCI was analyzed.Results Before treatment,apparent diffusion coefficient(ADC)values at lesion sites in study group were greater than those in control group and those after treatment,while fractional anisotropy(FA)was lower than that in control group and that after treatment(F=21.619;F=33.379,P<0.05).After treatment,scores of ASIA sensory and motor in study group were increased(t=4.717;t=2.637,P<0.05).ADC values in grade A-B group were lower than those in grade C-D group,while FA value,scores of ASIA upper limb sensory and motor were higher than those in grade C-D group(t=2.443;t=5.294;t=5.337;t=5.540,P<0.05).FA value was positively correlated with scores of ASIA sensory and motor(r=0.423;r=0.475,P<0.05).ADC values at lesion sites in improvement group were greater than those in non-improvement group,while FA value was lower than that in non-improvement group(t=3.542;t=3.620,P<0.05).ROC curves analysis showed that AUC of ADC combined with FA for predicting prognosis was 0.911,greater than that of ADC and FA alone(0.790,0.749)(Z=1.993;Z=2.182,P<0.05).Conclusion DTI can display cervical SCI early and can be applied in prognosis evaluation.