摘要
目的:采用磁共振扩散张量成像(MR-DTI)对腕管综合征(CTS)患者局部注射类固醇的疗效进行评价。方法:纳入本院临床确诊并接受超声引导下类固醇局部注射的CTS患者30例(30个腕管),分别于术前1周及术后1个月测量其正中神经(MN)在尺桡远端关节(DRUJ)、豌豆骨(P)、钩状骨(H)三个层面的部分各向异性值(FA)和表观扩散系数(ADC)值,并记录其波士顿CTS问卷评分,比较其差异并进行相关性分析。结果:与治疗前[(1.46±0.13)×10-3 mm 2/s]比较,局部注射类固醇后[(1.28±0.11)×10-3 mm 2/s]豌豆骨水平的ADC值降低(P<0.05),而其FA值未见升高(0.46±0.05 vs.0.48±0.08,P>0.05)。在DRUJ和H水平,FA值(0.54±0.05 vs.0.58±0.10;0.43±0.07 vs.0.44±0.11)和ADC值[(1.22±0.15)×10-3 mm 2/s vs.(1.15±0.19)×10-3 mm 2/s;(1.46±0.15)×10-3 mm 2/s vs.(1.43±0.12)×10-3 mm 2/s]在治疗前后未见明显变化(P>0.05)。豌豆骨水平的ADC差值与BCTQ评分差值呈正相关(r=0.681,P<0.05)。结论:MR-DTI可用于CTS患者保守治疗后的影像随访,豌豆骨水平的ADC值可用于CTS患者局部类固醇注射治疗后的疗效评价。
Objective:The purpose of this study was to evaluate the outcomes of corticosteroid injections using magnetic resonance diffusion tensor imaging(MR-DTI)in patients with carpal tunnel syndrome(CTS).Methods:MR-DTI was performed on 30 wrists of 30 patients with CTS one week before and one month after ultrasound-guided corticosteroid injections.Fractional anisotropy(FA)and apparent diffusion coefficient(ADC)of the median nerve(MN)at the levels of the distal radioulnar joint(DRUJ),pisiform bone(P),and hamate bone(H)were measured.Symptom relief were evaluated with the Boston Carpal Tunnel Syndrome Questionnaire(BCTQ)scale.Results:In comparison with baseline values[(1.46±0.13)×10-3 mm 2/s],post-injection ADC[(1.28±0.11)×10-3 mm 2/s]was significantly lower(P<0.05)but FA was not significantly higher(0.46±0.05 vs.0.48±0.08,P>0.05)at the pisiform bone level on the injected wrists.At the DRUJ and hamate bone levels,no obvious inter-scan change in FA(0.54±0.05 vs.0.58±0.10;0.43±0.07 vs.0.44±0.11,P>0.05)and ADC[(1.22±0.15)×10-3 mm 2/s vs.(1.15±0.19)×10-3 mm 2/s;(1.46±0.15)×10-3 mm 2/s vs.(1.43±0.12)×10-3 mm 2/s,P>0.05]was observed.The decrease in ADC values at the pisiform bone level was strongly correlated with the decrease in BCTQ scores(r=0.681,P<0.05).Conclusion:MR-DTI can be used as a method of follow-up for CTS patients treated with conservative management.ADC values measured at the level of the pisiform bone can be used to evaluate the outcomes of corticosteroid injection in patients with CTS.
作者
刘寒
何晓鹏
陈光祥
韩福刚
LIU Han;HE Xiao-peng;CHEN Guang-xiang(Department of Radiology,Affiliated Hospital of Southwest Medical University,Sichuan 646000,China)
出处
《放射学实践》
北大核心
2019年第11期1202-1206,共5页
Radiologic Practice
关键词
腕管综合征
磁共振成像
扩散张量成像
类固醇注射
疗效
Carpal tunnel syndrome
Magnetic resonance image
Diffusion tensor imaging
Steroids injections
Outcomes
