摘要
目的探讨选择性水激励脂肪抑制(PROSET)序列与三维T_(2)加权快速梯度回波(3D-T_(2)-FFE)序列在观察坐骨神经穿梨状肌变异中的差异及应用价值。方法使用Philips Ingenia 1.5TXD磁共振仪对26例健康志愿者行盆腔扫描,包括T_(1)WI轴位、PROSET序列及3D-T_(2)-FFE序列冠状位扫描。将后两者扫描数据在工作站中应用曲面重组(CPR)技术对坐骨神经重建,并观察其与梨状肌的关系。由两名医师对两种序列的后处理图像独立阅片,参照潘铭紫对国人坐骨神经与梨状肌关系的分型,按坐骨神经与梨状肌关系显示满意、不满意进行主观评价,对两种序列显示满意的例数采用卡方检验。结果26例志愿者均可在PROSET序列及3D-T_(2)-FFE序列中完成双侧坐骨神经重建,共计坐骨神经52支。坐骨神经在PROSET序列中呈稍低信号,在3D-T_(2)-FFE序列中呈高信号。两种序列均能发现坐骨神经穿梨状肌变异,共17支(32.7%),Ⅱ型变异16支(94.1%),Ⅳ型变异1支(5.9%)。坐骨神经走行正常时,PROSET序列与3D-T_(2)-FFE序列对神经与梨状肌关系显示满意,两者无明显差异(χ^(2)=2.120,P=0.145>0.005);坐骨神经穿梨状肌变异时,两者存在差异(χ^(2)=10.462,P=0.001<0.005),3D-T_(2)-FFE序列图像显示梨状肌内神经的满意例数高于PROSET序列图像。在两种序列中神经的信噪比无明显差异(t=1.851,P=0.069,P>0.05)。在神经上段,神经与骶骨的对比噪声比无明显差异(t=0.100,P=0.921,P>0.05)。在神经梨状肌段,神经与梨状肌的对比噪声比有明显差异(t=5.529,P=0.000,P<0.05),3D-T_(2)-FFE序列的CNR神经上段高于PROSET序列。结论PROSET序列及3D-T_(2)-FFE序列都有较高的软组织对比度,可以很好的显示坐骨神经走行。但坐骨神经穿梨状肌变异时,3D-T_(2)-FFE序列图像显示梨状肌内神经的满意例数要高于PROSET序列图像。在观察坐骨神经与梨状肌关系时,宜采用3D-T_(2)-FFE序列。
Objective To investigate the difference and application value of PROSET sequence and 3 D-T_(2)-FFE sequence in observing the variation between the sciatic nerve and the piriformis muscle.Methods 26 healthy volunteers(16 females,10 males,mean age 20.58±1.21 years)were scanned with Philips Ingenia 1.5 TXD MR,including T_(1)WI axial scan,PROSET sequence and 3 D-T_(2)-FFE sequence coronal scan.The latter two scanning data were reconstructed by curved surface reconstruction(CPR)in the workstation,and the relationship between sciatic nerve and piriformis muscle was observed.Two doctors read the post-processing images of the two sequences independently.Referring to Pan Mingzi’s classification of the relationship between sciatic nerve and piriformis muscle,they made a subjective evaluation according to the relationship between sciatic nerve and piriformis muscle.The number of cases with satisfactory display of the two sequences was tested by chi square test.Results 26 volunteers could complete bilateral sciatic nerve reconstruction in PROSET sequence and 3 D-T_(2)-FFE sequence,with a total of 52 sciatic nerves.The sciatic nerve showed slightly low signal in PROSET sequence and high signal in 3 D-T_(2)-FFE sequence.The variation of 17 branches could be found in both sequences including 16 branches(94.1%,16/17)of type II variation and 1 branch(5.9%,1/17)of type IV variation.When there is no variation,both PROSET sequence and 3 D-T_(2)-FFE sequence can show the relationship between nerve and piriformis muscle well,and there was no significant difference between them(χ^(2)=2.120,P=0.145>0.005).When the sciatic nerve penetrated the piriformis muscle,there was a difference between the two group(χ^(2)=10.462,P=0.001<0.005).There was no significant difference in signal to noise ratio between the two sequences(t=1.851,P=0.069,P>0.05).In the upper segment of the nerve,there was no significant difference in the contrast noise ratio between the nerve and the sacrum(t=0.100,P=0.921,P>0.05).In the piriformis segment of nerve,ther
作者
李梦参
常天静
吕喆
张滨
那曼丽
董含微
LI Mengshen;CHANG Tianjing;LYV Zhe(Department of Medical Imaging,Shougang Hospital,Peking University,Beijing 100041,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第11期2125-2129,共5页
Journal of Clinical Radiology
关键词
坐骨神经
梨状肌
磁共振神经成像
曲面重组
Sciatic nerve
Piriformis muscle
Magnetic resonance neuro-imaging
Curved surface reconstruction
