Diffusion Tensor Imaging of Symptomatic Nerve Roots in Patients with Cervical Disc Herniation
Diffusion Tensor Imaging of Symptomatic Nerve Roots in Patients with Cervical Disc Herniation
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DOI：
10.1016/j.acra.2013.11.005
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发表时间：
2014-03-01
影响因子：
4.8
通讯作者：
Shen, Jun
中科院分区：
文献类型：
--
作者：
Chen, Yue-Yao;Lin, Xiao-Feng;Shen, Jun
基本原理和目标：颈椎间盘退变可导致神经根压迫和严重症状，严重影响患者的生活质量。本研究的目的是探讨颈神经根弥散张量成像（DTI）的多项弥散指标变化及其与颈椎间盘突出症患者临床严重程度的关系。材料与方法：对18例有症状的患者和10例健康志愿者进行了颈神经根的高方向性DTI检查，常规颈椎间盘扫描后，在T型磁共振系统上进行检查。根据DTI数据计算各向异性分数（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD），并在同一患者的受累侧和未受累侧之间以及健康志愿者和有症状患者之间进行比较：侧与侧之间的相关性分析侧扩散度量差异和临床脊髓损伤神经学分类国际标准评分。DTI可清晰显示C5 ~ C8神经根。受压神经根的FA、MD、AD和RD分别为0.31 ± 0.091、2.06 ± 0.536、2.69 ± 0.657和1.75 ± 0.510 mm（2）/s。与健康志愿者健侧比较，患侧神经根FA降低（P <0.022），MD、AD、RD增加（P <0.035、P <0.047、P <0.012）。脊髓损伤患者的临床国际神经病学分类标准评分与MD呈负相关（r =-0.57，P = .002），AD（r =-0.451，P = .021），RD（r =-0.564，P = .003），但与FA无关结论：DTI技术可用于评价椎间盘突出症患者颈段神经根的显微结构异常。
Rationale and Objectives: Cervical disc degeneration can result in nerve root compression and severe symptoms that significantly impair the patient's quality of life. The purpose of this study is to investigate multiple diffusion metrics changes in the diffusion tensor imaging (DTI) of cervical nerve roots and their relationship with the clinical severity of patients with cervical disc herniation.Materials and Methods: High directional DTI of the cervical nerve roots was performed in 18 symptomatic patients and 10 healthy volunteers with a 3.0-T magnetic resonance System after a routine cervical disc scanning. The fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD); and radial diffusivity (RD) were calculated from the DTI data and compared between the affected and unaffected sides in the same patient and between healthy volunteers and symptomatic patients: The correlation between the side-to-side diffusion metric differences and the clinical International Standards for Neurological Classification of Spinal Cord Injury scores was analyzed.Results: C5-C8 nerve roots were clearly delineated with DTI. The FA, MD, AD, and RD Of compressed nerve roots were 0.31 +/- 0.091, 2,06 +/- 0.536,2.69 +/- 0.657, and 1.75 +/- 0.510 mm(2)/s, respectively. Compared to the unaffected side of healthy volunteers, the nerve roots Of the affected side-showed-decreased FA (P < .022) and increased MD (P < :035), AD (P < :047), and RD (P < .012). The clinical international Standards for Neurological Classification of Spinal Cord Injury Scores of the patients were negatively correlated with MD (r = -0.57, P = .002), AD (r = -0.451, P = .021), and RD (r = -0.564, P = .003) but not with FA (r = 0.004, P = .984),Conclusions: DTI can potentially be used to assess microstructural abnormalities in the cervical, nerve roots in patients with disc herniation.