Diffusion tensor imaging and tractography of the sciatic nerve: assessment of fractional anisotropy and apparent diffusion coefficient values relative to the piriformis muscle, a preliminary study
Diffusion tensor imaging and tractography of the sciatic nerve: assessment of fractional anisotropy and apparent diffusion coefficient values relative to the piriformis muscle, a preliminary study
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DOI：
10.1007/s00256-016-2557-6
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发表时间：
2017-03-01
影响因子：
2.1
通讯作者：
Sairyo, Koichi
中科院分区：
文献类型：
--
作者：
Wada, Keizo;Hashimoto, Takuya;Sairyo, Koichi
梨状肌综合征 (PMS) 的诊断不足。为了评估弥散张量成像和弥散张量纤维束成像作为通过坐骨神经功能评估来诊断 PMS 的创新工具的潜力，本研究的目的是评估重复性并评估梨状肌近端和远端水平的参数变化。坐骨神经的分数各向异性 (FA) 和表观弥散系数 (ADC) 在三个水平上由两名检查者使用纤维追踪方法各量化两次。在研究的第一部分中，使用组内相关系数 (ICC) 对 10 名健康志愿者进行了偏侧性和再现性评估。在研究的第二部分中，对十名连续坐骨神经痛患者的健康侧和有症状侧进行了评估。有3名患者的腰椎磁共振成像（MRI）没有发现任何发现。无症状患者的任何级别的FA或ADC值均不存在偏侧性。平均评估者内部 ICC 为 0.90，平均评估者间 ICC 为 0.87。坐骨神经痛患者有症状侧各水平的 FA 显着降低，ADC 显着升高。在腰椎 MRI 未发现任何结果的三名坐骨神经痛患者中，仅在梨状肌远端水平 FA 显着较低，ADC 显着较高。这些患者在超声引导下注射局麻药后疼痛完全缓解。弥散张量成像和弥散张量纤维束成像可能是诊断经前综合症的创新工具。
Piriformis muscle syndrome (PMS) is underdiagnosed. To evaluate the potential of diffusion tensor imaging and diffusion tensor tractography as innovative tools for the diagnosis of PMS by functional assessment of the sciatic nerve, the aims of this study are to assess the reproducibility and to evaluate the changes in the parameters at levels proximal and distal to the piriformis.Fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) of the sciatic nerve at three levels were quantified twice each by two examiners using the fiber-tracking method. In the first part of the study, laterality and reproducibility were evaluated using intraclass correlation coefficients (ICC) in ten healthy volunteers. In the second part of the study, the healthy side and symptomatic side were assessed in ten consecutive patients with sciatica. There were three patients with no findings on lumbar magnetic resonance imaging (MRI).There was no laterality in either FA or ADC values in asymptomatic patients at any level. The mean intra-rater ICC was 0.90 and the mean inter-rater ICC was 0.87. FA was significantly lower and ADC significantly higher on the symptomatic side at each level in patients with sciatica. In the three sciatica patients with no findings on lumbar MRI, FA was significantly lower and ADC was significantly higher only at levels distal to the piriformis. These patients experienced full pain relief after ultrasound-guided injection of local anesthesia.Diffusion tensor imaging and diffusion tensor tractography might be innovative tools for the diagnosis of PMS.