目的 探讨3D-T2W-FFE、3D-STIR-TSE、DWIBS三种序列腰骶丛神经显示、影像解剖和3D重建效果。 方法 收集49名志愿者常规腰椎磁共振和腰骶丛神经成像数据,其中3D-T2W-FFE 序列48例、3D-STIR-TSE序列47例、DWIBS 序列43例。计算三种序列神经根和骨骼肌的对比度噪声比(CNRN/M)、右侧骶1神经根直径及神经节体积;分别采用各自4等级评分比较这三种序列对腰骶丛神经的显示效果和3D重建效果。 结果 三种序列的CNR N/M不全相同,其中3D-T2W-FFE序列与3D-STIR-TSE、DWIBS序列均有统计学差异,P<0.05。三种序列的神经节体积无统计学差异(P=0.050)。三种序列的神经根直径不全相同,其中3D-STIR-TSE序列与DWIBS序列间有统计学差异(P<0.05)。三种序列神经显示评分不全相同,其中DWIBS序列与3D-T2W-FFE、3D-STIR-TSE序列均有统计学差异(P<0.05)。三种序列神经3D重建评分无统计学差异(P=0.025)。 结论 3D-T2W-FFE 序列和3D-STIR-TSE FFE序列神经显示和影像解剖评分无差别,较DWIBS序列好。三种序列神经3D重建评分无差别,其中DWIBS序列重建过程最易实现。
Abstract
Objective To investigate the effect of 3D reconstruction, lumbosacral plexus's display and image anatomical measurement of 3D-T2W-FFE, 3D-STIR-TSE and DWIBS sequences. Methods Data of 49 volunteers underwent conventional lumbar spine MRI and lumbosacral plexus neurography, including 48 cases of 3D-T2W-FFE, 47 cases of 3D-STIR-TSE and 43 cases of DWIBS sequence were collected. The contrast to noise ratio of nerve root and muscle (CNR N/M), the nerve root diameter and ganglion volume of the right sacral of the three sequences were calculated. The lumbosacral plexus's display effect and 3D reconstruction effect were evaluated and compared by different grade 4 scores respectively. Results The CNR N/M of the three sequences were not identical, there were statistical differences among the 3D-T2W-FFE sequence, the 3D-STIR-TSE and DWIBS sequences (P<0.05), there was no significant difference in ganglion volume among the three sequences (P=0.050). The nerve roots diameter of the three sequences were not identical, there were statistical differences between the 3D-STIR-TSE sequence and the DWIBS sequence(P<0.05). There was no statistical difference in neural 3D reconstruction score of the three sequences (P=0.025). Conclusions There is no statistical difference in the neural display and imaging anatomical score of 3D-T2W-FFE sequence and 3D-STIR-TSE sequence, which is better than DWIBS sequence. There is no statistical difference in the neural 3D reconstruction score of the three sequences, which the DWIBS sequence is easiest to achieve during reconstruction.
关键词
腰骶丛神经 /
磁共振神经成像 /
3D重建 /
图像信号 /
影像解剖
Key words
Lumbosacral plexus /
Magnetic Resonance Neurography /
3D reconstruction /
Image signal /
  /
  /
Image anatomy
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Menezes C M, de Andrade L M, Herrero C F, et al. Diffusion-weighted magnetic resonance (DW-MR) neurography of the lumbar plexus in the preoperative planning of lateral access lumbar surgery[J]. Eur Spine J, 2015, 24(4): 817-826.
[2] Wang H L, Jiang J Y, Lv F Z, et al. Magnetic resonance neurography in analysis of operative safety of transforaminal lumbar interbody fusion in Chinese subjects[J]. Orthop Surg, 2014, 6(3):203-209.
[3] Liu Y, Wang S, Yang C, et al. Retrospective study of the interlaminar approach for percutaneous endoscopic lumbar discectomy with the guidance of pre-operative magnetic resonance neurography[J]. Ann Transl Med, 2019, 7(7):145.
[4] 严斌, 孙永建, 欧阳汉斌, 等. 3D打印导航模块辅助腰椎椎弓根螺钉精确植入的应用研究[J]. 中国临床解剖学杂志, 2017, 35(2):156-159.
[5] Hofstadler B, Baumer P, Schwarz D, et al. MR neurography: normative values in correlation to demographic determinants in children and adolescents[J]. Clin Neuroradiol, 2019. DOI: 10.1007/s00062-019-00834-9.
[6] Chaves H, Bendersky M, Goni R, et al. Lumbosacral plexus root thickening: Establishing normal root dimensions using magnetic resonance neurography[J]. Clin Anat, 2018, 31(6):782-787.
[7] Takahara T, Hendrikse J, Kwee T C, et al. Diffusion-weighted MR neurography of the sacral plexus with unidirectional motion probing gradients[J]. Eur Radiol, 2010, 20(5):1221-1226.
[8] Choi G, Lee S H, Raiturker P P, et al. Percutaneous endoscopic interlaminar discectomy for intracanalicular disc herniations at L5-S1 using a rigid working channel endoscope[J]. Neurosurgery, 2006, 58(1 Suppl):S59-S68, S59-S68.
[9] Byun W M, Kim J W, Lee J K. Differentiation between symptomatic and asymptomatic extraforaminal stenosis in lumbosacral transitional vertebra: role of three-dimensional magnetic resonance lumbosacral radiculography[J]. Korean J Radiol, 2012,13(4): 403-411.
[10]李丽艳, 周顺科, 郭云志, 等. 腰椎间盘突出症的神经根三维磁共振选择性水激励脂肪抑制技术成像特征分析[J]. 中国全科医学, 2013,16(30):2848-2851.
[11]李勇, 孔祥泉, 杨帆, 等. MRI及3D-STIR序列联合应用在腰椎间盘突出症中的价值[J]. 临床放射学杂志, 2014, 33(1): 95-99.
[12]Skorpil M, Engstrom M, Nordell A. Diffusion-direction-dependent imaging: a novel MRI approach for peripheral nerve imaging[J]. Magn Reson Imaging, 2007, 25(3): 406-411.
[13]李程浩, 利晞, 黄勇, 等. 增强3D STIR序列在3.0T MRI腰骶神经根成像中的图像质量评估和应用价值讨论[J]. 医学影像学杂志, 2017, 27(12): 2361-2364.
[14]李冲, 杨杨, 朱恂, 等. 腰骶丛MRI形态学成像在诊断CIDP患者中的价值[J]. 中国医学计算机成像杂志, 2017, 23(6): 549-552.
基金
国家重点研发计划(2017YFC1103400);广东省省级科技计划项目(2017B090912006、2018B090944002);深圳市医疗卫生“三名工程”高层次医学团队(SZSM201612019)