本文選題：腕管綜合征　切入點：正中神經(jīng)　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：第一部分:三維雙回波穩(wěn)態(tài)進動序列在正常青年人腕管內(nèi)正中神經(jīng)的應(yīng)用研究目的探討正常青年人腕管內(nèi)正中神經(jīng)的MRI表現(xiàn)及解剖參數(shù),為診斷腕管綜合征(carpal tunnel syndrome,CTS)提供參考。方法選擇25例正常青年志愿者應(yīng)用3.0T磁共振三維雙回波穩(wěn)態(tài)進動序列進行非慣用手腕部掃描,測量腕管內(nèi)正中神經(jīng)橈骨遠(yuǎn)端及豆?fàn)罟菍用娼孛娣e(CSA1、CSA2),計算腫脹率(MNSR)、扁平率(MNFR)、腕橫韌帶弓形率(FRAR),將上述數(shù)據(jù)與年齡、腕圍、BMI進行相關(guān)性分析,并統(tǒng)計以上所有數(shù)據(jù)的95%置信區(qū)間。結(jié)果在三維雙回波穩(wěn)態(tài)進動序列上正中神經(jīng)表現(xiàn)為稍高信號,腕管內(nèi)肌腱呈低信號,腕管內(nèi)滑膜組織信號介于兩者之間,組織對比良好,正中神經(jīng)邊界顯示清晰。測量正中神經(jīng)CSA1及CSA2分別為8.34±1.46mm2、9.40±1.97mm2,MNSR為1.13±0.18,MNFR為2.41±0.73,FRAR為0.06±0.02;MNFR與腕圍、BMI之間存在統(tǒng)計學(xué)正相關(guān),與年齡無統(tǒng)計學(xué)相關(guān)性;CSA1與腕圍存在統(tǒng)計學(xué)負(fù)相關(guān),與年齡及BMI間無統(tǒng)計學(xué)相關(guān)性;MNSR、FRAR、CSA2與年齡、腕圍、BMI之間并無統(tǒng)計學(xué)相關(guān)性。結(jié)論三維回波穩(wěn)態(tài)進動序列有利于正中神經(jīng)的顯示,測量更準(zhǔn)確,有利于腕管綜合征的早期診斷。第二部分:3.0T MR DTI及DTT對正常青年人腕管內(nèi)正中神經(jīng)的定量分析目的運用DTI定量分析健康青年人腕管內(nèi)正中神經(jīng)部分功能參數(shù)值特點及DTT重建正中神經(jīng)纖維束。方法測量25名健康志愿者各層面正中神經(jīng)的FA值、ADC值及本征值E1、E2、E3,計算AD值、RD值,統(tǒng)計MNFA、MNAD、MNRD、MNADC值的均值。同時進行正中神經(jīng)DTT研究。各層面FA、AD、RD、ADC值及本征值采用單因素方差分析,采用折線圖描繪上述參數(shù)變化趨勢,統(tǒng)計上述參數(shù)95%置信區(qū)間。結(jié)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)各層面FA、RD值之間存在顯著差異(F=5.126、2.508,P=0.000、0.009),各層面AD、ADC及各本征值E1、E2、E3之間差異無統(tǒng)計學(xué)意義(P=0.239、0.602、0.239、0.878、0.878)。(3)DTI部分功能參數(shù)中除ADC值以外均表現(xiàn)出較明顯的近心端到遠(yuǎn)心端的變化趨勢。(4)MNFA、MNAD、MNRD、MNADC的95%置信區(qū)間上下限分別為(0.675,0.698)、(2.052,2.117)、(0.549,0.587)、(1.056,1.091)。(5)利用DTT可以連續(xù)、完整地重建顯示正中神經(jīng)纖維束,遠(yuǎn)端分支亦能顯示。結(jié)論應(yīng)用DTI及DTT技術(shù)可以定量描述正中神經(jīng)的各向異性及直觀顯示重建的正中神經(jīng)纖維束,可為診斷正中神經(jīng)病變提供定量的觀察指標(biāo)。
[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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.2;R688
，

本文編號：1699348