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腰骶神经MRI三维双 向波稳态水激发序 列成像分析

作者:张付志

所属单位:河南省平顶山市平煤神马医疗集团 总医院放射科 (河南 平顶山 467000)

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摘要

目的 分析腰骶神经MRI三维双向 波稳态水激发序列成像结果。方法 2017 年4月选择健康体检者30名为研究对象。 行常规MRI及三维双向波稳态水激发序列 对腰骶段脊椎进行冠状位扫描。将三维双 向波稳态水激发序列原始图像进行薄层最 大强度投影以及多平面重组。对图像进行 重建。评价左侧与右侧神经显示评分, 显示神经长度,神经节长度及宽度。结 果 所有研究对象均完成检查,未发现器 质性病变。三维双向波稳态水激发序列结 果中,腰骶神经,脊神经节,脑脊液为高 信号,骨骼肌为中等信号,骨质,脂肪, 大血管为低信号。左侧与右侧神经显示评 分、神经长度、神经节长度及宽度比较差 异无统计学意义(P>0.05)。L5神经长度 最长,其次为S1,L4、S2。从T12到S2, 神经节宽度呈逐渐增加的趋势,自T12-S1 神经节呈长度呈增加趋势,S2有所下降。 结论 MRI三维双向波稳态水激发序列用于 腰骶神经检查能清晰显示神经主干、神经 节等情况。

Objective To analyze 3D double-echo steady-state with water excitation MRI in lumbosacral nerves. Methods 30 cases for physical examination in April 2017 were selected as subjects. All cases received 3D double-echo steady-state with water excitation MRI in lumbosacral nerves. The maximum intensity projection of the thin layer and the multiplanar reconstruction of the original image of the two-dimensional bi-directional steady state water excitation sequence are carried out. Image was reconstructed. The left and right nerve display scores, the nerve length, length and width of the ganglion were evaluated. Results All the subjects were examined and no organic lesions were found. 3D double-echo steady-state with water excitation MRI showed that the lumbosacral nerves, spinal ganglia, and cerebrospinal fluid are high signals, skeletal muscle is medium signal, and bone, fat, and large vessels are low signals. The score of nerve, length of nerve, length and width of nerve between the right and the left nerve were not statistically different(P >0.05). The length of L5 nerve was the longest, followed by S1, L4 and S2. From T12 to S2, the ganglion width showed a gradually increasing trend, and from T12 to S1, the ganglion length showed a gradually increasing trend, and S2 has declined. Conclusion 3D double-echo steady-state with water excitation MRI in lumbosacral nerves can clearly show the nerve trunk, ganglia and so on.

【关键词】MRI;三维双向波稳态水激发 序列;腰骶神经

【中图分类号】R323.4+3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.03.041

前言

腰骶神经的腰丛由第12胸神经前支的一部分,第1-3腰神经前支和 第4腰神经前支的一部分组成,骶丛由腰骶干及全部骶神经与尾神经前 支组成。腰骶神经根自上而下斜向走行,其周边结构复杂,常规MRI与 CT均很难对其完整清晰显示。目前临床上常用的成像技术有稳态自由 进动序列以及MR神经成像序列,但均需要结合抑制脂肪技术,加强神 经与周围组织对比。水激发与扩散加权是主要的抑脂技术。选择性激 励原则属于水激发抑脂方法,选择性激励水或者脂肪质子产生信号, 获得脂肪或者水高对比度的清晰图像。双回波稳态序列是一种特殊的 稳态自由进动序列,信号由三维稳态进动快速成像序列与其时间反转 序列合并为一副图像,既突出长T2液体信号,也突出显示解剖结构。 既往主要用于软骨成像,有学者将其用于面神经成像,取得了较好的 效果,我们将该成像技术用于腰骶神经成像,现将结果报道如下。