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DTI成像技术在脊 髓震荡损伤中的应 用价值

作者:陈惠恩 孙井松 蔡厚洪 梁 斌 钟永青 陈慧红 叶秋萍 汪海波

所属单位:广州医科大学附属乐从医院放射科 (广东 佛山 528315)

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摘要

目的 探讨弥散张量成像(DTI) 在脊髓震荡损伤中的应用价值。方法 收集脊髓震荡损伤17例作为研究组(A 组),32例非脊髓震荡髓损伤的脊髓损 伤病例作为对照组(B组);选取与A、B 组年龄、部位相匹配的49例健康志愿 者作为对照组(C组)。所有病例行MR平 扫和DTI扫描,测量A组和B组脊髓损伤 节段平均FA值和平均ADC值,测量C组 (与前2组相同节段脊髓)平均FA值和 平均ADC值,并分析A组与C组、A组与 B组组间差异。结果 B组平均ADC值为 (1301.35±221.15)×10-6mm2 /s,平均FA值 为(377.12±67.31)×10-3;C组平均ADC 值为(827.63±218.54)×10-6mm2 /s,平 均FA值为(540.03±38.14)×10-3。A组平 均ADC值(1103.25±49.65)×10-6mm2 /s, 较C组升高,有统计学意义(P<0.05),较 B组降低(P<0.05),有统计学意义;A组 平均FA值(423.53±58.42)×10-3,较C组 下降,有统计学意义(P<0.01),较B组升 高,有统计学意义(P<0.05)。结论 DTI 对脊髓震荡伤有较高的敏感性,对脊髓 损伤的分级诊断有重要意义。

Objective To investigate the application values of DTI in spinal cord concussion injury(SCC). Methods Routine MR scan and DTI were accomplished in 17 cases of SCC, study group A, and 32 cases of spinal cord injury without SCC, control group B, and also in 49 cases of healthy volunteers occupied same ages and spinal cord segments with group A and B, normal control group C. Average FA values and ADC values at the injury segments of group A and B, and also at the same segments with group A and B in group C were calculated. The Average differences of FA values and ADC values between group A and B, and also between group A and group C were analyzed. Results The significantly statistical difference of increased average ADC value (1103.25±49.65)×10- 6 mm2 /s and decreased average FA value(423.53±58.42)×10-3 in group A than average ADC value(827.63±218.54)×10-6mm2 /s and average FA value (540.03±38.14)×10- 3 in group C were found. The significantly statistical difference of decreased average ADC value and increased FA value in group A compared with the average ADC value (1301.35±221.15)×10-6mm2 /s and average FA value (377.12±67.31)×10-3 in group B existed. Conclusion DTI is highly sensitive to SCC and possess important significance in grading diagnosis of spinal cord injury

【关键词】脊髓震荡;弥散张量成像; ADC值;FA值

【中图分类号】R651.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.10.010

前言

脊髓震荡(spinal cord concussion,SCC)是闭合性脊髓损伤后 造成的最轻的原发性脊髓损伤,具有短暂性的脊髓功能障碍[1]。以往 物理检查难以找到脊髓实质性损伤的证据,临床多凭经验进行治疗和 判断预后,具有盲目性。近年来,弥散张量成像(diffusion tensor imaging, DTI)在脊髓损伤中的应用是研究的热点,能对颈髓损伤的 早期改变进行定量分析[2-3],并可作为脊髓损伤后运动功能恢复的指 标[4]。但DTI在SCC损伤中的应用尚未见报导,本研究通过回顾性分 析,探讨DTI成像技术在脊髓震荡损伤中的应用价值,旨在为临床制订 治疗方案及判断预后提供客观依据。