摘要
目的观察腰骶丛MR神经成像(MRN)联合弥散张量成像(DTI)诊断1A型腓骨肌萎缩症(CMT1A)的价值。方法对44例经临床诊断的CMT1A患者(CMT1A组)及10名健康对照(对照组)行腰骶丛MRN及DTI,对CMT1A患者行CMT神经病学评分(CMTNS),包括CMTNS总分、CMT查体评分、CMT下肢评分及CMT下肢运动评分;根据L5神经根(NR)增粗程度将CMT1A组分为轻度增粗(n=16)、中度增粗(n=14)及明显增粗(n=14)亚组。比较组间及CMT1A各亚组间L4、L5双侧神经根(NR-L4、NR-L5)、股神经(FN)及坐骨神经(SN)直径、各向异性分数(FA)、平均弥散率(MD)、轴向弥散率(AD)和径向弥散(RD)的差异,分析CMT1A患者腰骶丛神经直径及DTI参数与CMTNS的相关性。结果相比对照组,CMT1A组NR-L4、NR-L5、FN及SN直径均增大,NR-L4、NR-L5、FN及SN的FA均降低,NR-L4及SN的MD和RD均升高(P均<0.05),组间其余参数差异均无统计学意义(P均>0.05)。CMT1A组内明显增粗亚组NR-L4、NR-L5、FN及SN直径均较轻度增粗亚组增大,而NR-L4和SN的MD、NR-L4的RD均高于轻度增粗亚组(P均<0.05);各亚组间其余参数差异均无统计学意义(P均>0.05)。CMT1A患者腰骶丛神经直径与CMTNS均呈正相关(r_(s)=0.304~0.501),SN的MD和RD、NR-L5的AD与CMT下肢运动评分均呈正相关(r_(s)=0.234、0.264、0.214),FN的AD与CMTNS总分和CMT查体评分(r_(s)=0.243、0.211)、SN的AD与CMTNS总分及CMT查体评分(r_(s)=0.244、0.219)均呈正相关(P均<0.05);其他腰骶丛神经DTI参数与CMTNS无明显相关性。结论腰骶丛MRN联合DTI可用于诊断CMT1A及监测疾病进展。
Objective To observe the value of lumbosacral plexus MR neurography(MRN)combining with diffusion tensor imaging(DTI)for diagnosing Charcot-Marie-Tooth disease 1A(CMT1A).Methods Lumbosacral plexus MRN and DTI examinations were performed on 44 patients with clinically diagnosed CMT1A(CMT1A group)and 10 healthy controls(control group).CMT neuropathy score(CMTNS)were performed on CMT1A patients,including CMTNS total score,CMT examination score,CMT lower extremity score and CMT lower extremity motor_(s)core.According to the degrees of L5 nerve root(NR)thickening,patients in CMT1A were divided into mildly thickened(n=16),moderately thickened(n=14)and obviously thickened(n=14)subgroups.The diameter,fractional anisotropy(FA),the mean diffusivity(MD),axial diffusivity(AD)and radial diffusivity(RD)of L4 and L5 NR(NR-L4,NR-L5),femoral nerve(FN)and sciatic nerve(SN)were compared between CMT1A group and control group,also among 3 subgroups in CMT1A group.The correlations of the diameter and DTI parameters of plexus lumbosacralis with CMTNS were analyzed.Results Compared with control group,the diameters of NR-L4,NR-L5,FN and SN increased significantly,FA of NR-L4,NR-L5,FN and SN decreased,while MD and RD of NR-L4 and SN increased in CMT1A group(all P<0.05),but no significant difference of other parameters was found between groups(all P>0.05).Within CMT1A group,the diameters of NR-L4,NR-L5,FN and SN in obviously thickened subgroup were significantly larger,MD of NR-L4 and SN as well as RD of NR-L4 were all significantly higher than those in mildly thickened subgroup(all P<0.05),while the other parameters were not significantly different among 3 subgroups(all P>0.05).The diameters of lumbosacral nerve were significantly positively correlated with CMTNS(r_(s)=0.304-0.501).MD and RD of SN,also AD of NR-L5 were positively correlated with CMT lower extremity motor_(s)core(r_(s)=0.234,0.264,0.214),while AD of FN(r_(s)=0.243,0.211)were positively correlated with CMTNS total score and CMT examination score,so were AD of SN(r_(s)=0.244,
作者
孙兴文
袁慧书
刘小璇
朱雨辰
樊东升
张立华
SUN Xingwen;YUAN Huishu;LIU Xiaoxuan;ZHU Yuchen;FAN Dongsheng;ZHANG Lihua(Department of Radiology,Peking University Third Hospital,Beijing 100191,China;Department of Neurology,Peking University Third Hospital,Beijing 100191,China)
出处
《中国医学影像技术》
CSCD
北大核心
2023年第9期1384-1388,共5页
Chinese Journal of Medical Imaging Technology
关键词
沙尔科-马里-图思病
磁共振成像
弥散张量成像
Charcot-Marie-Tooth disease
magnetic resonance imaging
diffusion tensor imaging
