3.0T MR三维双回波稳态进动序列及DTI、DTT技术在正常青年人腕管内正中神经的应用研究与定量分析

发布时间：2018-04-02 07:17

  本文选题：腕管综合征　切入点：正中神经　出处：《安徽医科大学》2017年硕士论文

【摘要】：第一部分:三维双回波稳态进动序列在正常青年人腕管内正中神经的应用研究目的探讨正常青年人腕管内正中神经的MRI表现及解剖参数,为诊断腕管综合征(carpal tunnel syndrome,CTS)提供参考。方法选择25例正常青年志愿者应用3.0T磁共振三维双回波稳态进动序列进行非惯用手腕部扫描,测量腕管内正中神经桡骨远端及豆状骨层面截面积(CSA1、CSA2),计算肿胀率(MNSR)、扁平率(MNFR)、腕横韧带弓形率(FRAR),将上述数据与年龄、腕围、BMI进行相关性分析,并统计以上所有数据的95%置信区间。结果在三维双回波稳态进动序列上正中神经表现为稍高信号,腕管内肌腱呈低信号,腕管内滑膜组织信号介于两者之间,组织对比良好,正中神经边界显示清晰。测量正中神经CSA1及CSA2分别为8.34±1.46mm2、9.40±1.97mm2,MNSR为1.13±0.18,MNFR为2.41±0.73,FRAR为0.06±0.02;MNFR与腕围、BMI之间存在统计学正相关,与年龄无统计学相关性;CSA1与腕围存在统计学负相关,与年龄及BMI间无统计学相关性;MNSR、FRAR、CSA2与年龄、腕围、BMI之间并无统计学相关性。结论三维回波稳态进动序列有利于正中神经的显示,测量更准确,有利于腕管综合征的早期诊断。第二部分:3.0T MR DTI及DTT对正常青年人腕管内正中神经的定量分析目的运用DTI定量分析健康青年人腕管内正中神经部分功能参数值特点及DTT重建正中神经纤维束。方法测量25名健康志愿者各层面正中神经的FA值、ADC值及本征值E1、E2、E3,计算AD值、RD值,统计MNFA、MNAD、MNRD、MNADC值的均值。同时进行正中神经DTT研究。各层面FA、AD、RD、ADC值及本征值采用单因素方差分析,采用折线图描绘上述参数变化趋势,统计上述参数95%置信区间。结果(1)MNFA值=0.686±0.089、MNAD值=2.085±0.263mm2/s、MNRD值=0.568±0.151mm2/s、MNADC值=1.073±0.140mm2/s。(2)各层面FA、RD值之间存在显著差异(F=5.126、2.508,P=0.000、0.009),各层面AD、ADC及各本征值E1、E2、E3之间差异无统计学意义(P=0.239、0.602、0.239、0.878、0.878)。(3)DTI部分功能参数中除ADC值以外均表现出较明显的近心端到远心端的变化趋势。(4)MNFA、MNAD、MNRD、MNADC的95%置信区间上下限分别为(0.675,0.698)、(2.052,2.117)、(0.549,0.587)、(1.056,1.091)。(5)利用DTT可以连续、完整地重建显示正中神经纤维束,远端分支亦能显示。结论应用DTI及DTT技术可以定量描述正中神经的各向异性及直观显示重建的正中神经纤维束,可为诊断正中神经病变提供定量的观察指标。
[Abstract]:Part I: application of three dimensional dual echo steady-state precession sequence in the median nerve of the carpal tunnel in normal young people objective to investigate the MRI manifestations and anatomical parameters of the median nerve in the carpal tunnel of normal young people, and to provide a reference for the diagnosis of carpal tunnel syndrome.Methods Twenty five healthy young volunteers were studied by using 3.0T magnetic resonance three-dimensional dual-echo steady-state precession sequence to scan the unconventional wrist.The sectional area of the distal radius and lentiform bone of the median nerve in the carpal tunnel was measured. The swelling rate, the flat rate and the arcuate rate of the transverse carpal ligament were calculated. The correlation between the above data and age and BMI of wrist circumference was analyzed, and the 95% confidence interval of all the above data was calculated.Results the median nerve showed a slightly higher signal on the three dimensional dual echo steady-state precession sequence, the tendon in the carpal tunnel was low signal, the signal of synovial tissue in the carpal tunnel was between the two signals, the tissue contrast was good and the median nerve boundary was clear.There was no significant correlation between BMI and wrist circumference.Conclusion Three-dimensional echo steady-state precession sequence is beneficial to the display of median nerve, accurate measurement and early diagnosis of carpal tunnel syndrome.Part 2: 3.0T Mr DTI and DTT quantitative analysis of median nerve in normal young carpal tunnel objective to analyze the functional parameters of the median nerve in the normal young carpal tunnel by DTI and to reconstruct the median nerve bundle with DTT.Methods the FA value, ADC value and intrinsic value E _ (1) E _ (2) E _ (2) E _ (3) of median nerve in 25 healthy volunteers were measured. The AD value and Rd value were calculated, and the mean value of MNADX MNRDX MNADC was calculated.At the same time, the median nerve DTT was studied.The ADC value and eigenvalue of FADX / RDX are analyzed by single factor ANOVA, the variation trend of the above parameters is described by the broken line diagram, and the 95% confidence interval of the above parameters is calculated.The upper and lower limits of 95% confidence interval of MNAD / MNAD / MNADC are 0.675 / 0.698U / 2.052U / 2.1172 / 0.549 / 0.587N ~ (1.065) / 1.091.5) the DTT can be used for continuous use of MNADC, and the results show that the maximum confidence interval of MNADC is 1.05% and the lower limit of 95% confidence interval of MNADC is 0.67 5 / 0.698.The median nerve fibers were reconstructed completely and the distal branches were also displayed.Conclusion DTI and DTT techniques can be used to quantitatively describe the anisotropy of the median nerve and visualize the reconstructed median nerve fiber bundles, which can provide a quantitative index for the diagnosis of median neuropathy.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R688
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本文编号：1699348