摘要
目的:探讨MR零回波时间(ZTE)成像技术在评估神经根型颈椎病椎间孔骨性狭窄中的应用价值。方法:临床诊断为神经根型颈椎病的患者,除常规颈椎MR和CT检查,还同时行T_(1)WI、T_(2)WI双斜矢状面和ZTE序列扫描,评估椎间孔骨性狭窄情况。以CT作为参照标准,计算各MR序列评估椎间孔骨性狭窄的敏感度和特异度。采用Kappa检验评估各MR序列与CT对椎间孔骨性狭窄评估结果的一致性,以及评价者之间对椎间孔狭窄评估结果的一致性。采用配对χ^(2)检验比较ZTE与常规MR序列敏感度和特异度的差异。采用Wilcoxon符号秩和检验,将CT的严重程度评分与各MR序列进行比较。结果:29例患者(348个椎间孔)中,CT共检出68个椎间孔存在骨性狭窄,ZTE检出60个,斜位T_(2)WI检出40个,斜位T_(1)WI检出35个,常规T_(2)WI、T_(1)WI分别检出21个和18个,ZTE较常规T_(1)WI、T_(2)WI序列具有更高的敏感度,ZTE对椎间孔骨性狭窄的评估与CT具有很好的一致性(Kappa值=0.85)。对于ZTE序列不同评价者间一致性好(kappa值=0.78)。对于狭窄严重程度评分ZTE序列与CT无显著差异(Z=0,P=1),常规T_(1)WI、T_(2)WI均有低估椎间孔狭窄程度的趋势。结论:与常规T_(1)WI、T_(2)WI序列相比,ZTE序列能够更可靠地评估神经根型颈椎病椎间孔骨性狭窄。
Objective:The purpose of this study was to explore the application value of osseous foraminal stenosis of the cervical spine using zero echo time technique of magnetic resonance imaging(MRI).Methods:In addition to conventional MR and CT scan,the oblique MR sagittal scan with T_(1)WI,T_(2)WI and ZTE sequences was needed in patients with cervical spondylotic radiculopathy,to evaluate the bony stenosis of intervertebral foramina.The detection sensitivity and specificity of the above each MR sequence in osseous foraminal stenosis were calculated respectively with CT scan as reference.Kappa coefficient was used to evaluate the detection consistency in osseous stenosis of intervertebral foramen among different MR and CT sequences and among different readers.And Pairedχ^(2)-test was used to compare the sensitivity and specificity of different sequences.Besides,the Wilcoxon signed rank test was used to compare the severity score of each MR sequences with CT sequence.Results:A total of 68 osseous foraminal stenosis were detected by CT,60 by ZTE,40 by oblique T_(2)WI,35 by oblique T_(1)WI,21 by conventional T_(2)WI and 18 by T_(1)WI.ZTE was of higher sensitivity than conventional T_(1)WI and T_(2)WI sequences.The evaluation of bony stenosis of intervertebral foramen by ZTE was in good agreement with that of CT(Kappa value=0.85).The inter-observer agreement of ZTE was good(Kappa value=0.78).There was no statistically significant difference between ZTE and CT(Z=0,P=1).Conventional T_(1)WI and T_(2)WI sequences underestimated the degree of foraminal stenosis.Conclusion:ZTE sequence can more reliably detect foraminal stenosis in cervical spondylotic radiculopathy with a higher sensitivity compared with conventional T_(1)WI and T_(2)WI sequences.
作者
王聪
鲁毅
欧阳治强
凌冰冰
曾一真
孙学进
WANG Cong;LU Yi;OU-YANG Zhi-qiang(Department of Radiology,the First Affiliated Hospital of Kunming Medical University,Kunming 650000,China)
出处
《放射学实践》
CSCD
北大核心
2021年第11期1424-1429,共6页
Radiologic Practice
关键词
磁共振成像
零回波时间
神经根型颈椎病
Magnetic resonance imaging
Zero echo time
Cervical spondylotic radiculopathy
