本文選題：腰椎間盤移位　切入點(diǎn)：體層攝影術(shù)　出處：《山西醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:對60例受試者的腰4-腰5椎間盤進(jìn)行磁共振擴(kuò)散張量成像(DTI)掃描并進(jìn)行定量分析,比較正常腰椎間盤纖維環(huán)和椎間盤突出后纖維環(huán)的不同并量化特征,探討MR擴(kuò)散張量成像在腰椎間盤突出癥中的應(yīng)用價(jià)值。方法:①采用1.5T磁共振(1.5T Signa GE)對60名受試者進(jìn)行L4-L5椎間盤矢狀位T1WI、T2WI與軸位T2WI掃描,并行軸位DTI序列掃描,仰臥位,體線圈,頭先進(jìn)。②收集本院2014年4月-2014年10月對30例(男18例、女12例)經(jīng)MRI檢查證實(shí)有腰椎間盤突出患者行L4-L5椎間盤DTI序列掃描,以及健康人(男15例、女15例)對照組(MRI腰椎間盤掃描陰性)30例行DTI檢查.③將整理的數(shù)據(jù)輸入到GE ADW 4.4工作站中,采用Functool后處理功能描繪各向異性分?jǐn)?shù)(FA)圖、示蹤纖維(FT)圖后對每幅圖進(jìn)行數(shù)據(jù)觀察及測量。④觀察兩組椎間盤纖維環(huán)的連續(xù)性和完整性,測量正常組纖維環(huán)前緣、后緣和病例組斷裂纖維環(huán)以及髓核的FA值,計(jì)量資料采用均數(shù)±標(biāo)準(zhǔn)差的形式表示,配對資料間的比較采用配對t檢驗(yàn);成組資料的組間比較采用t檢驗(yàn)。采用簡單線性相關(guān)方法分析組間的相關(guān)性。結(jié)果:①1.5T磁共振FT圖能夠清晰顯示纖維環(huán)內(nèi)纖維走行、板層形態(tài)與排列,正常纖維環(huán)呈連續(xù)、均質(zhì)的環(huán)形,板層纖維交錯(cuò)有序,而椎間盤突出患者突出部可見纖維環(huán)斷裂、板層結(jié)構(gòu)無序。②正常組纖維環(huán)FA值明顯高于其髓核的FA值,說明纖維環(huán)和髓核有不同的擴(kuò)散特性。③正常組纖維環(huán)在FA圖上示連續(xù)均等的環(huán)形圖像,且FA值連續(xù)均等(0.732±0.034)。④病例組纖維環(huán)斷裂處FA值明顯降低(0.12±0.056),而斷裂周圍的FA值出現(xiàn)升高(0.49±0.13)。結(jié)論:DTI-FT是一項(xiàng)可以無創(chuàng)的顯示和評價(jià)腰椎間盤纖維環(huán)形態(tài)和完整性的新技術(shù),能夠發(fā)現(xiàn)纖維環(huán)是否發(fā)生斷裂并找到斷裂的位置,是常規(guī)磁共振檢查的有利補(bǔ)充。FA值能表示椎間盤內(nèi)水分子的彌散能力,可以量化的反映椎間盤突出時(shí)纖維環(huán)發(fā)生的改變以及退變早期髓核的病理生理過程。磁共振擴(kuò)散張量技術(shù)可以對腰椎間盤突出的診斷提出影像學(xué)上的依據(jù),并有助于了解椎間盤突出癥的發(fā)病機(jī)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 鹵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 鹵0.0344.The FA value decreased significantly by 0.12 鹵0.056m, but the FA value around the fracture increased by 0.49 鹵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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R445.2;R681.53

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