DTI对急性颈髓损伤ASIA不同残损等级的研究

发布时间：2018-07-06 06:47

本文选题：脊髓损伤 + 磁共振成像　；参考：《中国临床医学影像杂志》2017年01期

【摘要】：目的:研究急性颈髓损伤(Spinal cord injury,SCI)DTI备参数值在ASIA不同残损等级的临床应用价值。方法:回顾性分析急性SCI常规MRI T_2WI高信号34例患者,48小时内行MR-DTI检查,测量病变区FA、ADC、λ_∥、λ_⊥值,临床采用ASIA等级标准,A级5例、B级6例、C级10例、D级13例,健康组15例相近年龄段志愿者,测量C_(3/4)~C_(5/6)相应椎间盘平面。采用单因素方差(ANOVA)分析DTI参数值在ASIA A~D级差异,t检验分析DWI高信号(DWI高信号区)与边缘区(T_2WI高信号区)DTI参数差异。结果:A~D级与健康组比较FA、ADC、λ_∥、λ_⊥值均具有统计学意义(F=51.90,13.30,24.70,13.01,P0.001)。A级与B、C、D级两两比较FA值、ADC值、λ_∥值有统计学意义(P0.05),FA值、λ_∥值随着ASIA残损等级降低呈下降趋势,ADC值在A级降低、B~D级升高,λ_⊥值升高,B级与A、C、D级两两比较差异有统计学意义(P0.05),A、C、D级比较差异无统计学意义(P0.05)。DTT显示A、B级损伤区域神经纤维束肿胀、中断,C、D级损伤区神经纤维束完整。DWI高信号区与T_2WI高信号区ADC、λ_∥、λ_⊥值具有统计学意义(P0.05),FA值均降低无统计学意义(P0.05)。DTT显示DWI高信号区神经纤维束连续性中断。结论:FA值、λ_∥值是评价急性SCI AISA不同残损等级敏感指标,ADC值越低损伤程度越重,DTT直观显示神经纤维束损伤部位和损伤程度,为临床治疗提供更多影像学证据。
[Abstract]:Objective: to study the clinical application value of DTI-ready parameters in Asia with different grade of injury of spinal cord injury (Spinal cord injury-sci). Methods: MR-DTI was performed in 34 patients with acute sci on conventional T _ 2WI within 48 hours. The values of FAA DCA, 位 _ , 位 _ 螕 were measured. Asia grade standard was used in 5 patients with grade A, 6 patients with grade B, 10 patients with grade C and 13 patients with grade D. The intervertebral disc plane of C _ (3 / 4) C _ (5 / 6) was measured in 15 healthy volunteers of similar age. Single factor variance (ANOVA) was used to analyze DTI parameter differences in Asia Agna D grade difference test. The difference of DTI parameters between DWI high signal region (DWI high signal area) and edge area (T 2WI high signal area) was analyzed. Results compared with the healthy group, the FAA DCA, 位 _ /, 位 _ 螕 values were statistically significant (F _ 51.90 ~ 13.30 ~ 24.70 ~ 13.70 ~ 13.01 / P0.001) .A and B ~ C ~ (D) were compared with each other in FA value and ADC value, 位 _ / D value was statistically significant (P0.05) FA value, 位 _ / value decreased with the decrease of Asia damage grade and ADC value decreased in A grade. There was no significant difference between B grade and C D grade (P0.05). DTT showed the swelling of nerve fiber bundles in the injured area of Agna B grade, and there was no significant difference between D grade and D grade (P0.05), and there was no significant difference between D grade and B grade (P0.05), DTT showed swelling of nerve fiber bundles in the injured area of Agna B grade, and there was no significant difference in D grade (P0.05). There was no significant difference in the values of ADCA, 位 _ /, 位 _ (P 0.05) between the hyperintense area of DWI and the high signal area of T _ 2WI (P0.05). There was no significant decrease in FA value (P0.05) .DTT showed that the continuity of nerve fiber bundle in high signal area of DWI was interrupted. Conclusion the sensitivity index of different damage grade of acute sci AISA is the ratio of fraction FA to 位 _ (1). The lower the ADC value is, the more serious the injury degree is. DTT can directly display the location and degree of injury of nerve fiber bundle, and provide more imaging evidence for clinical treatment.
【作者单位】：滨州医学院烟台附属医院;滨州医学院;
【基金】：山东省自然科学基金(ZR2015HM081) 山东省烟台市科技计划项目(2014WS049)
【分类号】：R651.2

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