128排螺旋CT重建同层显示对腰骶神经根变异的诊断价值

The Value of 128-Slice Spiral CT Reconstruction in the Diagnosis of Lumbosacral Nerve Root Variation

目的探究128排螺旋CT重建同层显示与常规MRI序列在腰骶神经根变异(lumbosacral nerve root animalise,LSNRA)临床诊断中的应用。方法以2021年12月—2022年12月在福建中医药大学附属第三人民医院因腰腿疼痛就诊的69例患者为研究对象,所有患者先进行CT扫描,再进行神经重建同层显示,同时进行MRI扫描检测,比较不同检测手段的LSNRA发现率,并采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价其诊断价值。结果69例患者神经在CT和MRI下L2~S2均获得较好显影。MRI发现5例神经根变异患者,发现率7.25%(5/69),分别是Ⅱ-1型(1例)、Ⅱ-2型(2例)、Ⅱ-3型(1例)、Ⅱ-4型(1例);常规CT扫描共发现4例神经根变异患者,发现率5.80%(4/69),分别为Ⅱ-1型(1例)、Ⅱ-2型(1例)、Ⅱ-3型(1例)、Ⅱ-4型(1例);CT重建神经同层显示共发现10例神经根变异患者,发现率为14.49%(10/69),分别为Ⅱ-1型(2例)、Ⅱ-2型(2例)、Ⅱ-3型(2例)、Ⅱ-4型(3例)、Ⅴ型(1例)。MRI、常规CT、CT重建神经同层的发现率差异无统计学意义(P>0.05)。MRI、常规CT和CT重建神经同层的ROC曲线下面积分别为0.676、0.710、0.847。结论128排螺旋CT重建同层显示对LSNRA具有较高的诊断价值,其发现率显著高于CT和常规MRI。

Objective To study the application of 128-slice spiral CT reconstruction with the same layer display and conventional MRI sequence in clinical diagnosis of lumbosacral nerve root animalise(LNRA).Methods A total of 69 patients with back and leg pain treated in the Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine from December 2021 to December 2022 were selected as the research objects.CT scanning was performed in all patients,followed by nerve reconstruction in the same layer display,and MRI scanning was performed at the same time to compare the detection rate of LSNRA by different detection methods.Receiver operating characteristic curve(ROC) was used to evaluate its diagnostic value.Results The nerves of 69 patients were well developed in L2-S2 under CT and MRI.Five patients with nerve root variation were found in MRI,with a finding rate of 7.25%(5/69),which were Ⅱ-1(1 case),Ⅱ-2(2 cases),Ⅱ-3(1 case),and Ⅱ-4(1 case).A total of 4 patients with nerve root variation were found by conventional CT scanning,the detection rate was 5.80%(4/69),which were Ⅱ-1(1 case),Ⅱ-2(1 case),Ⅱ-3(1 case),and Ⅱ-4(1 case).A total of 10 patients with nerve root variation were found in the same layer of CT reconstructed nerve,the finding rate was 14.49%(10/69),and they were Ⅱ-1(2 cases),Ⅱ-2(2 cases),Ⅱ-3(2 cases),Ⅱ-4(3cases),and Ⅴ(1 case).There was not statistical significance in the finding rate of MRI,conventional CT and CT reconstruction in the same layer(P>0.05).The areas under ROC curve of MRI,conventional CT and CT reconstructed nerve were 0.676,0.710 and 0.847,respectively.Conclusion The 128-slice spiral CT reconstructed with the same layer display has a high diagnostic value for LSNRA,and its detection rate is significantly higher than that of CT and conventional MRI.