正常马尾神经的磁共振扩散张量成像研究 - 中华医学会.DOCVIP

正常马尾神经的磁共振扩散张量成像研究 【摘 要】 目的 探讨磁共振扩散张量成像（DTI））equina（CE） healthy young volunteers, T2WI and DTI were preformed from the upper middle level of the lumbar 2 and inferior margin of sacral 1 in axial direction in the slice thickness of 3 mm and without interslice gap. The CE and LSNR from lumbar 2 to sacral 1 were reconstructed and the values of FA and DCavg of the CE and LSNR were measured at the sites of each intervertebral foramen. Results From lumbar 2 to sacral 1, the CE had a good display. The LSNR were visualized in 60 bundles (83%). The values of FA and DCavg of CE were 0.359±0.068 and 3.711±0.595×10-9 mm2/s and the values of FA and DCavg of LSNR were 0.322±0.040 and 3.753±0.647×10-9 mm2/s individually. Based on Student t test, the values of FA had significant difference between the CE and LSNR, P 0.001.The values of DCavg had no significant difference between CE and LSNR, P 0.05. Conclusion DTI provides a non-invasive method to display the CE. Through the measurement of FA and DCavg in normal CE and LSNR, the insight has been promoted to the level of the changes of water molecular in assessing CE and LSNR. [Key words] MRI, DTI, Cauda equina, FA, DCavg MRI扩散张量成像（Diffusion Tensor Imaging, DTI）已被广泛应用于中枢神经系统的神经纤维束成像 [1-2]，但在马尾神经（Cauda Equina, CE）和腰骶脊神经根（lumbosacral spinal nerve roots，LSNR)方面的应用较少[3]。然而，由于各种原因导致的CE或/和LSNR损伤，常常是引起患者症状或产生后遗症的主要原因，临床实践需要明确神经受损和治疗后改善的程度[4]。CE的DTI较脑部难度大，主要是由于CE浸泡在腰骶椎管的脑脊液中，易受脑脊液流动、部分容积效应和周围骨壁磁敏感伪影的影响，加之大血管博动、呼吸运动带来的干扰，这需要快速和高分辨率的DTI成像序列来显示其神经纤维束[3]。 资料和方法 从2012年5月至9月，经骨科检查正常的9例青年志愿者，男性4例，年龄21-27岁（平均：23.25±2.63岁）；女性5例，年龄21-26岁（22.08±2.17岁）。在签署磁共振成像（Magnetic Resonance Imaging, MRI）检查知情同意书后，行MRI检查。MRI设备为GE (General Electricity, USA), Signa 1.5T HDXT。首先行胸10至骶椎末端的矢状面T1WI和T2WI扫描，明确腰骶椎管正常，然后行腰2椎体中上部水平至骶1椎体下缘的轴面T2WI和DTI扫描。利用Cardiac 8 通道阵列线圈，T2WI扫描的方向、层厚和层间距与DTI扫描相同。T2WI轴面扫描参数：重复时间（Repetition Time, TR））））”和“Target”方法标记腰2椎体中部和腰4椎体下缘水平的兴趣区（region of interest, ROI）Average Diffusion Coefficient, DCavg）图，FA阈值为0.18,分节段叠加重建CE和LSNR。在叠加重建时避免椎间盘纤维环的影响