DTI联合DTT对外伤致胫神经损伤的应用研究

发布时间：2018-05-04 11:29

本文选题：磁共振 + 扩散张量成像　；参考：《临床放射学杂志》2017年06期

【摘要】：目的探讨扩散张量成像(DTI)技术联合扩散张量纤维示踪(DTT)技术在外伤致胫神经损伤中的价值。方法回顾性分析15例经手术证实不同程度胫神经损伤患者(损伤组)及15名健康志愿者(对照组)的膝关节DTI资料,定量分析两组膝关节胫神经各向异性(FA)值及表观扩散系数(ADC)值。采用独立样本t检验分析两组间FA值、ADC值差异;进一步分析FA值及ADC值的受试者工作特征(ROC)曲线,评价其对胫神经损伤诊断的准确性,并采用DTT对胫神经进行纤维示踪,评估神经纤维走向、形态。结果损伤组FA值为0.51±0.05,对照组FA值为0.58±0.05,两组差别具有统计学意义(t=-4.509,P0.05);损伤组ADC值为(1.43±0.07)×10~(-3)mm~2/s,对照组ADC值为(1.35±0.10)×10~(-3)mm~2/s,两组差别具有统计学意义(t=2.725,P0.05);FA值的ROC曲线下面积(AUC)为0.884,ADC值的ROC曲线AUC为0.724。结论 DTI技术可以定量分析胫神经损伤的损伤程度,并且在对中等以及重度神经损伤的诊断上FA值较ADC值具有较高诊断效能,但其不能从形态学上对胫神经予以显示。DTT技术则可清晰显示胫神经损伤后不同损伤程度的神经纤维形态变化。两者联合可大大提高对胫神经损伤诊断的正确率,并且能够对胫神经损伤后修复等进行随访和评估。
[Abstract]:Objective to investigate the value of diffusion Zhang Liang DTI technique combined with Zhang Liang fiber tracing technique in tibial nerve injury. Methods the DTI data of knee joint of 15 patients with different degree of tibial nerve injury (injury group) and 15 healthy volunteers (control group) were analyzed retrospectively. The values of anisotropy and apparent diffusion coefficient (ADC) of tibial nerve in the two groups were quantitatively analyzed. The difference of FA value and ADC value between the two groups was analyzed by independent sample t-test, and the operating characteristics of FA value and ADC value were further analyzed to evaluate the accuracy of diagnosis of tibial nerve injury, and DTT was used to trace the tibial nerve. To evaluate the direction and shape of nerve fibers. Results the FA value of the injury group was 0.51 卤0.05, and that of the control group was 0.58 卤0.05. The difference between the two groups was statistically significant, the ADC value of the injury group was 1.43 卤0.07 脳 10 ~ (-3) mm ~ (-2) / s, and the ADC value of the control group was 1.35 卤0.10 脳 10 ~ (-3) mm ~ (-2) / s. The area of ROC curve with significant difference between the two groups was 0.884ADCs (ROC / AUC = 0.72443). Conclusion DTI technique can quantitatively analyze the degree of tibial nerve injury, and FA value is more effective than ADC value in the diagnosis of moderate and severe nerve injury. But it can not display the tibial nerve morphologically. DTT can clearly show the changes of the nerve fibers in different degree after the tibial nerve injury. The combination of the two can greatly improve the diagnostic accuracy of tibial nerve injury, and can be followed up and evaluated after tibial nerve injury.
【作者单位】：河北北方学院研究生部;中国人民解放军第251医院影像科;
【分类号】：R445.2;R688

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