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扩散张量成像定量分析评估腰椎间盘突出微创术后神经修复的可行性研究 被引量:8

Feasibility of diffusion tensor imaging quantitative analysis in evaluation of nerve repair after minimally invasive surgery for lumbar disc herniation
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摘要 前瞻性纳入2017年12月至2018年9月河北医科大学第三医院经临床及MRI确诊,并接受经皮椎间孔镜下髓核摘除术(PTED)治疗的19例腰椎间盘单侧侧后方突出患者,于术前1 d,术后3、30、90 d行腰5(L5)、骶1(S1)神经根扩散张量成像(DTI)。由2名放射科医师于L5、S1患侧神经近、中、远节段及同节段健侧相应部位以"播点"法勾画感兴趣区(ROI ),测量DTI参数各向异性分数(FA)和表观扩散系数(ADC)值,计算每侧神经3个ROI的平均值。采用配对t检验比较患侧与健侧神经DTI参数的差异,手术前后DTI参数的比较采用单因素方差分析或Kruskal-Wallis H检验。结果显示:(1)术前1 d L5神经患侧和健侧FA值分别为0.35±0.03、0.45±0.01, S1患侧和健侧分别为0.36±0.02、0.46±0.02,L5、S1患侧神经根FA值低于健侧(t=-10.188、-37.683,P均<0.001);L5患侧ADC值为(1.65±0.13)×10-3 mm2/s、健侧(1.39±0.12)×10-3 mm2/s,S1患侧(1.63±0.05)×10-3 mm2/s、健侧(1.44± 0.08)×10-3 mm2/s,患侧高于健侧,差异有统计学意义(t=8.527、11.832,P均<0.001)。(2)从术前1 d至术后90 d,患侧L5、S1神经FA值逐渐升高,ADC值逐渐减低。术后90 d L5、S1患侧和健侧神经根DTI参数比较差异无统计学意义(P均>0.05)。表明DTI可用于定量评估腰骶神经PTED术后修复状况。
作者 刘志鹏 孙英彩 崔浩 崔建岭 张为 Liu Zhipeng;Sun Yingcai;Cui Hao;Cui Jianling;Zhang Wei(Department of Radiology,Qinhuangdao Jungong Hospital,Hebei Province,Qinhuangdao 066000,China;Department of Radiology,Third Hospital of Hebei Medical University,Hebei Province Biomechanical Key Laboratory of Orthopedics,Shijiazhuang 050051,China;Department of Spine Surgery,Third Hospital of Hebei Medical University,Hebei Province Biomechanical Key Laboratory of Orthopedics,Shijiazhuang 050051,China)
出处 《中华放射学杂志》 CAS CSCD 北大核心 2020年第4期356-359,共4页 Chinese Journal of Radiology
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