MR扩散张量成像对腰椎间盘突出症的诊断价值

发布时间：2018-03-18 06:40

本文选题：腰椎间盘移位　切入点：体层摄影术　出处：《山西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:对60例受试者的腰4-腰5椎间盘进行磁共振扩散张量成像(DTI)扫描并进行定量分析,比较正常腰椎间盘纤维环和椎间盘突出后纤维环的不同并量化特征,探讨MR扩散张量成像在腰椎间盘突出症中的应用价值。方法:①采用1.5T磁共振(1.5T Signa GE)对60名受试者进行L4-L5椎间盘矢状位T1WI、T2WI与轴位T2WI扫描,并行轴位DTI序列扫描,仰卧位,体线圈,头先进。②收集本院2014年4月-2014年10月对30例(男18例、女12例)经MRI检查证实有腰椎间盘突出患者行L4-L5椎间盘DTI序列扫描,以及健康人(男15例、女15例)对照组(MRI腰椎间盘扫描阴性)30例行DTI检查.③将整理的数据输入到GE ADW 4.4工作站中,采用Functool后处理功能描绘各向异性分数(FA)图、示踪纤维(FT)图后对每幅图进行数据观察及测量。④观察两组椎间盘纤维环的连续性和完整性,测量正常组纤维环前缘、后缘和病例组断裂纤维环以及髓核的FA值,计量资料采用均数±标准差的形式表示,配对资料间的比较采用配对t检验;成组资料的组间比较采用t检验。采用简单线性相关方法分析组间的相关性。结果:①1.5T磁共振FT图能够清晰显示纤维环内纤维走行、板层形态与排列,正常纤维环呈连续、均质的环形,板层纤维交错有序,而椎间盘突出患者突出部可见纤维环断裂、板层结构无序。②正常组纤维环FA值明显高于其髓核的FA值,说明纤维环和髓核有不同的扩散特性。③正常组纤维环在FA图上示连续均等的环形图像,且FA值连续均等(0.732±0.034)。④病例组纤维环断裂处FA值明显降低(0.12±0.056),而断裂周围的FA值出现升高(0.49±0.13)。结论:DTI-FT是一项可以无创的显示和评价腰椎间盘纤维环形态和完整性的新技术,能够发现纤维环是否发生断裂并找到断裂的位置,是常规磁共振检查的有利补充。FA值能表示椎间盘内水分子的弥散能力,可以量化的反映椎间盘突出时纤维环发生的改变以及退变早期髓核的病理生理过程。磁共振扩散张量技术可以对腰椎间盘突出的诊断提出影像学上的依据,并有助于了解椎间盘突出症的发病机制。
[Abstract]:Objective: to compare the different and quantitative characteristics of the fibrous ring of normal lumbar intervertebral disc and the fibrous ring of intervertebral disc herniation in 60 subjects by Mr diffusion imaging DTI (DTI) scan of lumbar 4-lumbar intervertebral disc (L4 L5). To evaluate the value of Mr diffusive Zhang Liang imaging in lumbar disc herniation methods 60 subjects were examined by 1.5T Signa GE in L4-L5 sagittal and axial T1WIT T2WI, axial DTI sequence, supine position and body coil, respectively. From April 2014 to October 2014, 30 patients (18 males and 12 females) with L4-L5 disc herniation were examined by MRI, and 15 healthy persons (male 15). In the control group, 30 cases were examined by DTI. 3 the data were input into GE ADW 4.4 workstation, and the anisotropic fractions were depicted by Functool postprocessing function. The continuity and integrity of the fibrous ring of intervertebral disc were observed and the FA values of the fibrous ring and nucleus pulposus of the normal group, the posterior edge and the case group were measured. The measurement data were expressed in the form of mean 卤standard deviation, and the paired t test was used to compare the paired data. T test was used to compare the data among groups. Correlation between the groups was analyzed by simple linear correlation method. Results the fibers in the fibrous ring could be clearly shown in the FT diagram of the 1: 11.5T MRI, the lamellar shape and arrangement were clearly displayed, and the normal fibrous rings were continuous. The fibrous rings were broken in the protrusions of the patients with disc herniation. The FA value of the fibrous rings in the normal group was significantly higher than that in the nucleus pulposus. It shows that there are different diffusion characteristics between the fibrous ring and the nucleus pulposus. 3 in the normal group, the fibrous ring shows a continuous and equal annular image on the FA map. The FA value of the fibrous ring fracture in the group of 0.732 卤0.0344.The FA value decreased significantly by 0.12 卤0.056m, but the FA value around the fracture increased by 0.49 卤0.130.Conclusion the ratio DTI-FT is a new noninvasive technique for displaying and evaluating the morphology and integrity of the fibrous ring of lumbar intervertebral disc. The ability to find the rupture of the fibrous ring and find the location of the fracture is a good supplement to conventional MRI. FA value can indicate the diffusion ability of water molecules in the disc. It can quantitatively reflect the changes of the fibrous ring during disc herniation and the pathophysiological process of nucleus pulposus in the early stage of degeneration. Mr diffusive Zhang Liang technique can provide imaging basis for the diagnosis of lumbar disc herniation. It is helpful to understand the pathogenesis of intervertebral disc herniation.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.2;R681.53

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