發(fā)布時間：2018-07-06 06:47

  本文選題：脊髓損傷 + 磁共振成像　； 參考：《中國臨床醫(yī)學(xué)影像雜志》2017年01期

【摘要】：目的:研究急性頸髓損傷(Spinal cord injury,SCI)DTI備參數(shù)值在ASIA不同殘損等級的臨床應(yīng)用價值。方法:回顧性分析急性SCI常規(guī)MRI T_2WI高信號34例患者,48小時內(nèi)行MR-DTI檢查,測量病變區(qū)FA、ADC、λ_∥、λ_⊥值,臨床采用ASIA等級標(biāo)準(zhǔn),A級5例、B級6例、C級10例、D級13例,健康組15例相近年齡段志愿者,測量C_(3/4)~C_(5/6)相應(yīng)椎間盤平面。采用單因素方差(ANOVA)分析DTI參數(shù)值在ASIA A~D級差異,t檢驗(yàn)分析DWI高信號(DWI高信號區(qū))與邊緣區(qū)(T_2WI高信號區(qū))DTI參數(shù)差異。結(jié)果:A~D級與健康組比較FA、ADC、λ_∥、λ_⊥值均具有統(tǒng)計(jì)學(xué)意義(F=51.90,13.30,24.70,13.01,P0.001)。A級與B、C、D級兩兩比較FA值、ADC值、λ_∥值有統(tǒng)計(jì)學(xué)意義(P0.05),FA值、λ_∥值隨著ASIA殘損等級降低呈下降趨勢,ADC值在A級降低、B~D級升高,λ_⊥值升高,B級與A、C、D級兩兩比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),A、C、D級比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。DTT顯示A、B級損傷區(qū)域神經(jīng)纖維束腫脹、中斷,C、D級損傷區(qū)神經(jīng)纖維束完整。DWI高信號區(qū)與T_2WI高信號區(qū)ADC、λ_∥、λ_⊥值具有統(tǒng)計(jì)學(xué)意義(P0.05),FA值均降低無統(tǒng)計(jì)學(xué)意義(P0.05)。DTT顯示DWI高信號區(qū)神經(jīng)纖維束連續(xù)性中斷。結(jié)論:FA值、λ_∥值是評價急性SCI AISA不同殘損等級敏感指標(biāo),ADC值越低損傷程度越重,DTT直觀顯示神經(jīng)纖維束損傷部位和損傷程度,為臨床治療提供更多影像學(xué)證據(jù)。
[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.
【作者單位】： 濱州醫(yī)學(xué)院煙臺附屬醫(yī)院;濱州醫(yī)學(xué)院;
【基金】：山東省自然科學(xué)基金(ZR2015HM081) 山東省煙臺市科技計(jì)劃項(xiàng)目(2014WS049)
【分類號】：R651.2

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