弥散成像技术在腰椎间盘突出症诊疗中的应用进展

Application progress of diffusion imaging technology in the diagnosis and treatment of lumbar disc herniation

腰椎间盘突出症(lumbar disc herniation,LDH)是临床常见的脊柱疾病,可导致患者下肢疼痛、无力、麻木甚至出现刺痛、烧灼样神经感觉异常的症状,严重影响生活质量。目前临床常用的影像学检查主要有X线、CT以及MRI。但在LDH诊疗的过程中会经常出现临床症状与影像学结果不吻合的情况,且MRI无法显示神经损伤的程度。MRI弥散成像技术是目前在活体上测量水分子弥散运动与成像的唯一方法,主要包括弥散加权成像(diffusion weighted imaging,DWI)和弥散张量成像(diffusion tensor imaging,DTI)。近年来,随着脉冲序列技术的改进以及高强度磁场的应用,MRI弥散成像技术逐渐应用于腰椎神经损伤的诊疗,能够无创获得受累神经纤维狭窄或中断的图像。本文基于弥散成像技术的原理,深入剖析其在LDH诊断和治疗中的应用现状,并分析其存在的局限和探讨未来的发展方向,以期为实现LDH的精准诊疗提供依据及思路。

Lumbar disc herniation(LDH)is a common clinical spine disease,which can lead to lower limb pain,weakness,numbness and even tingling and burning nerve paraesthesia,seriously affecting the quality of life of the patients.At present,X-ray,CT and MRI are commonly used in clinical imaging.However,in the process of diagnosis and treatment of LDH,clinical symptoms often do not coincide with imaging results,and MRI cannot show the degree of nerve injury.MRI diffusion imaging technique is currently the only method to measure the diffusion motion and imaging of water molecules in vivo,mainly including diffusion weighted imaging(DWI)and diffusion tensor imaging(DTI).In recent years,with the improvement of pulse sequence technology and the application of high-intensity magnetic field,MRI diffusion imaging technology has been gradually applied to the diagnosis and treatment of lumbar nerve injury,which can obtain non-invasive images of the stenosis or interruption of the involved nerve fibers.Based on the principle of diffusion imaging technology,this article analyzes the current status of its application in the diagnosis and treatment of LDH,and analyzes its limitations and discusses the future development direction,in order to provide basis and ideas for the realization of accurate diagnosis and treatment of LDH.