摘要
目的:探讨磁共振弥散张量成像(DTI)在腰椎间盘突出症神经根受压损伤程度中的诊断效果及其与视觉模拟疼痛(VAS)评分、Oswestry功能障碍指数问卷(ODI)评分的相关性。方法:选择医院收治的68例腰腿痛及放射性坐骨神经痛患者,均行MR DTI检查,测定受压侧神经根表观弥散系数(ADC)值、各向异性分数(FA)值,并以手术检查结果作为“金标准”与DTI检查结果进行比较;采用VAS及ODI评分量表评估腰椎间盘突出症神经根受压损伤程度,采用Spearman相关分析软件分析DTI参数ADC值和FA值与VAS及ODI评分的相关性。结果:在68例患者手术结果中,腰椎间盘突出症神经根受压损伤确诊46例(占67.65%),DTI检查诊断符合率为76.47%,诊断灵敏度为80.43%,特异度为68.18%。腰椎间盘突出症神经根受压损伤患者FA值低于不伴神经根受压损伤患者,差异有统计学意义(t=8.391,P<0.05);ADC值、VAS评分及ODI评分均高于不伴神经根受压损伤患者,差异有统计学意义(t=6.674,t=9.287,t=7.116;P<0.05)。Spearman相关分析中腰椎间盘突出症神经根受压损伤患者FA值与VAS及ODI评分呈负相关(r=-0.614,r=-0.498;P<0.05);ADC值与VAS及ODI评分呈正相关性(r=0.623,r=0.535;P<0.05)。结论:DTI用于腰椎间盘突出症神经根受压损伤中能获得较高的确诊率,且与损伤程度VAS及ODI评分存在强相关性,可为临床诊疗提供影像学依据。
Objective:To investigate the diagnostic effect of magnetic resonance(MR)diffusion tensor imaging(DTI)in the degree of nerve root compression injury of the protrusion of lumbar intervertebral disc and its correlation with the score of visual analogue scale(VAS)and the score of Oswestry dysfunction index(ODI)questionnaire.Methods:A total of 68 patients with pain in waist and lower extremity and radiating sciatica were selected,and all of them underwent MR DTI examination to determine the apparent diffusion coefficient(ADC)value and fractional anisotropy(FA)value of nerve root of the side of compression.The surgical result was used as golden standard to compare with DTI examination result.The VAS and ODI were adopted to assess the degree of nerve root compression injury of the protrusion of lumbar intervertebral disc,and Spearman correlation analysis software was used to analyze the correlation between DTI parameters(ADC value and FA value)and the scores of VAS and ODI.Results:In 68 patients,46 cases(67.65%)were confirmed as nerve root compression injury of the protrusion of lumbar intervertebral disc by surgical examination.The diagnostic accordance rate,diagnostic sensitivity and specificity of DTI examination were 76.4%,80.43%and 68.18%,respectively.The FA value of patients with nerve root compression injury of the protrusion of lumbar intervertebral disc was significantly lower than that of patients without nerve root compression injury(t=8.391,P<0.05).The ADC value,VAS score and ODI score of patients with nerve root compression injury of the protrusion of lumbar intervertebral disc were significantly higher than those of patients without nerve root compression injury(t=6.674,t=9.287,t=7.116,P<0.05).The results of Spearman correlation analysis showed that the FA value of patients with nerve root compression injury of the protrusion of lumbar intervertebral disc was negatively correlated with VAS and ODI scores(r=-0.614,r=-0.498,P<0.05),respectively.In addition,the ADC value was positively correlated with VAS scores and ODI scores(r=0.623,r=0.535,P<0.05),respectively.Conclusion:DTI that is used in diagnosis of nerve root compression injury of the protrusion of lumbar intervertebral disc can obtain higher confirmation rate,and it is strong correlation with the VAS score and ODI score of injury degree,which can provide imaging evidence for clinical diagnosis and treatment.
作者
鲁雪红
马娟
郭辉
李建江
LU Xue-hong;MA Juan;GUO Hui(Imaging Center,Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University,Urumchi 830000,China.;不详)
出处
《中国医学装备》
2022年第11期93-96,共4页
China Medical Equipment
基金
新疆维吾尔自治区自然科学基金(2017D01C300)“基于MRI多模态成像与MMPs对布鲁菌性脊柱炎发病机制的实验研究”
新疆医科大学附属中医医院院级课题(ZYY201807)“DTI在腰椎间盘突出症神经根受压损伤程度及预后预测的临床研究”。
