选择性激励技术在腰椎间盘突出症中的应用价值
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摘要
目的观察和探讨磁共振PROSET(PRinciple of selective excitation technique)技术对腰骶神经根显像及在腰椎间盘突出症中的应用价值,为手术治疗解除腰椎间盘突出症神经根受压提供客观的影像学依据。方法在常规MRI基础上采用三维快速梯度回波(3D FFE)技术作冠状面腰骶部神经根PROSET成像45例,所有图像均经3D最大信号强度投影(MIP)后处理。结果PROSET序列在诊断椎间盘突出症脊神经根压迫病例中优于常规MRI,其灵敏度(96.2%)、特异度(75%)、阳性预测值(96.2%)、阴性预测值(75%)、准确度(90%)均高于常规MRI(87.5%、50%、87.5%、50%、80%)。志愿者15例,腰骶脊神经根正常结构显示良好,能清晰地显示硬膜囊、神经根、脊神经节及节前和节后一段脊神经纤维。结论MRPROSET图像有利于神经根的显示,PROSET成像术能直观地显示腰骶部脊神经根走行及受压情况,供临床诊断和治疗时参考。
Objective:To investigate and oberservate application value of principle of selective excitation technique depicting the lumbosacral nerve root and lumbar disc herniation,providing obcjtive image basis for operation threaping lumbar disc herniation lead to nerve root compression.Methods:PROSETwas performed with 3D FFE on coronal image in lumbosacral nerve root of 45 cases basise on common magnetic resonance imaging,maximum intensity projection(MIP)was used for every image reconstruction.Results:PROSET is advantaged to conventional MRI in diagnosis lumbosacral nerve roots compression,its sensitivity 96.2%、specificity 75%、positive predictive value 96.2%、nedeative predictive value 75%、ccuracy 93.3%all exceeding magnetic resonance imaging(87.5%、50%、87.5%、50%、80%).In 15 volutters cases,Lumhosacral nerve roots were well emonstrated in primary images of PROSET and were observed with multiangle in MIP images.Conclusion:magnetic resonance imaging principle of selective excitation technigue can clearly observate nerve root and nerve root compression,As a reference for clinic diagnosis and therapy.
Objective:To investigate and oberservate application value of principle of selective excitation technique depicting the lumbosacral nerve root and lumbar disc herniation,providing obcjtive image basis for operation threaping lumbar disc herniation lead to nerve root compression.Methods:PROSETwas performed with 3D FFE on coronal image in lumbosacral nerve root of 45 cases basise on common magnetic resonance imaging,maximum intensity projection(MIP)was used for every image reconstruction.Results:PROSET is advantaged to conventional MRI in diagnosis lumbosacral nerve roots compression,its sensitivity 96.2%、specificity 75%、positive predictive value 96.2%、nedeative predictive value 75%、ccuracy 93.3%all exceeding magnetic resonance imaging(87.5%、50%、87.5%、50%、80%).In 15 volutters cases,Lumhosacral nerve roots were well emonstrated in primary images of PROSET and were observed with multiangle in MIP images.Conclusion:magnetic resonance imaging principle of selective excitation technigue can clearly observate nerve root and nerve root compression,As a reference for clinic diagnosis and therapy.
引文
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[14]秦东京,高文彬,张培功.L3-4、L4-5、L5-S1椎间盘与硬膜囊和脊神经的距离及临床意义[J].实用放射学杂志,2000,11:(16)653-655.
[15]朱建平,刘丽丽.腰椎间孔狭窄症临床诊治现状[J]。骨与关节损伤杂志,2001,3:156-158
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[19]Shen J,Wang HY,Chen J Y,etall Morphologic analysis of normal human lumbar dorsal root ganglion by 3D MR imaging[J]AJNR,2006,27:2098-21031
[20]AotaY,Niwa,Yoshikawa.Magnetic resonance imaging an magnetic resonance myelography in the presurgical diagnosis of lumbar foraminal stenosis[J].Spine,2007,32(8):896-903.
[21]Glaser C,Faber S,Eckstein F,etal.Optimization and validation of arapid high-resolution T1-W 3D flash water excitation MRI sequence for the quantitative assessment of articular cartilage volume and thickness[J].Magn Reson Imaging,2001,19(2):177-185.
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[23]冉鹏程,柴晓明,李松柏.ROSET序列对腰骶神经根变异的诊断价值[J].中国医学影像技术,2007,23(11)1608-1611.
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