摘要
目的探讨MRI冠状面多回波回复梯度回波(C-MERGE)序列对椎间孔外型腰椎间盘突出症(ELDH)的诊断价值。方法横断面研究。纳入2019年3月—2023年4月滨州医学院烟台附属医院和烟台市烟台山医院经手术及组织病理确诊的ELDH患者50例,其中男29例、女21例,年龄22~82(58.1±11.3)岁,病程2~24(8.1±3.8)个月,患者均为单侧单节段受累,受累节段为L_(2/3)1例、L_(3/4)4例、L_(4/5)17例、L_(5)/S_(1)28例。所有患者接受C-MERGE和冠状面T_(2)加权像(C-T_(2)WI)两种序列的MR扫描。观察并比较两种序列对突出椎间盘的检出率和受压神经根(神经根成角、变细、深压迹和肿胀)的显示率,并对两种序列图像清晰度评分。结果本组50例患者C-MERGE和C-T_(2)WI序列对突出椎间盘的检出率分别为100%(50/50)、94%(47/50),差异无统计学意义(χ^(2)=1.33,P=0.250)。C-MERGE序列对神经根成角、变细、深压迹、肿胀的显示率分别为78%(39/50)、60%(30/50)、72%(36/50)、46%(23/50),高于C-T_(2)WI序列的64%(32/50)、40%(20/50)、52%(26/50)、28%(14/50),差异均有统计学意义(χ^(2)=5.14、5.79、5.79、5.82,P值均<0.05)。C-MERGE序列的突出椎间盘以及神经根成角、变细、深压迹、肿胀的图像清晰度评分均为3.00(3.00,3.00)分,高于C-T_(2)WI序列的2.00(1.00,2.00)、2.00(1.00,2.25)、2.00(1.00,2.25)、2.00(1.00,2.00)、2.00(1.00,2.00)分,差异均有统计学意义(Z=6.13、5.40、5.40、5.56、5.83,P值均<0.001)。结论相比于C-T_(2)WI,C-MERGE对突出椎间盘和神经根受压程度的显示更敏感,也更清晰,可作为常规横断面、矢状面MRI的重要补充序列,是ELDH有效的影像学诊断方法之一。
Objective This study aimed to investigate the diagnostic value of MRI coronal multi-echo gradient echo(C-MERGE)sequence in external foraminal lumbar disc herniation(ELDH).Methods A cross-sectional study was conducted.A total of 50 ELDH patients diagnosed by surgery and histopathology from Yantai Affiliated Hospital of Binzhou Medical College and Yantai Yantai Mountain Hospital from March 2019 to April 2023 were included.Among them,29 were males and 21 were females,aged 22-82(58.1±11.3)years,and the course of disease was 2-24(8.1±3.8)months.All patients had unilateral single-segment involvement,including L_(2/3)1 case,L_(3/4)4 cases,L_(4/5)17 cases and L_(5)/S_(1)28 cases.All patients underwent MRI scans of both C-MERGE and coronal T_(2)WI(C-T_(2)WI)sequences.The detection rate of disc herniation and the display rate of compressed nerve roots(nerve root angulation,thinning,deep indentation,and swelling)of the two sequences were observed and compared.The image clarity of disc herniation and nerve root compression of the two sequences was scored and compared.Results Among the 50 patients,the detection rates of C-MERGE and C-T_(2)WI sequences for disc herniation were 100%(50/50)and 94%(47/50),respectively,and no significant difference in the detection rates was found between the two sequences(χ^(2)=1.33,P=0.250).The display rates of nerve root angulation,nerve root thinning,nerve root deep impression,and nerve root swelling were 78%(39/50),60%(30/50),72%(36/50),and 46%(23/50),respectively.The display rates of C-T_(2)WI sequences were 64%(32/50),40%(20/50),52%(26/50),and 28%(14/50),respectively,and C-MERGE sequences were superior to C-T_(2)WI sequences.A significant difference in the display rate was found between the two sequences(χ^(2)=5.14,5.79,5.79,5.82,all P values<0.05).The image resolution of disc herniation,nerve root angulation,nerve root thinning,nerve root deep indentation,and nerve root swelling in C-MERGE sequences were all 3.00(3.00,3.00)points,which were higher than those of C-T_(2)WI sequences of 2
作者
李淑玲
孙振中
曲德鑫
朱振利
谭江威
沈晓君
刘旭林
Li Shuling;Sun Zhenzhong;Qu Dexin;Zhu Zhenli;Tan Jiangwei;Shen Xiaojun;Liu Xulin(Department of Radiology,Yantaishan Hospital of Yantai City,Yantai 264001,China;Yantai International Travel Healthcare Center,Yantai 264001,China;Department of Education Division,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,China;Department of Spinal Surgery,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,China;Department of Radiology,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,China)
出处
《中华解剖与临床杂志》
2024年第4期239-243,共5页
Chinese Journal of Anatomy and Clinics
基金
山东省烟台市科技计划(2021YD072,2015WS069,2011236)。
关键词
椎间盘移位
椎间孔外型腰椎间盘突出症
多回波回复梯度回波
磁共振成像
诊断
Intervertebral disc displacement
External foraminal lumbar disc herniation
Multiple-echo recalled gradient echo
Magnetic resonance imaging
Diagnosis
