摘要
目的 通过对比健康成人腰椎的轴向加压动力位磁共振(axial loaded positional MRI, AL-P MRI)与传统MRI的影像结果,探讨其在腰椎管狭窄诊疗中的初步应用价值。方法 本实验入组6名健康受试者,予以AL-P MRI检查,记录受试者下腰椎3个节段(L3/L4、L4/5和L5/S1)在非轴向加压中立位、非轴向加压仰伸位、非轴向加压屈曲位、轴向加压中立位、轴向加压仰伸位和轴向加压屈曲位体位下的矢状位椎管前后径(anteroposterior diameter, APD)、矢状面椎间孔面积(foraminal area, FA)、横断位硬膜囊面积(dural sac cross-sectional area, DCSA)、终板夹角(endplate Angle, EA)及活动度(range of motion, ROM)的数值,并进行相应分析。结果 所有受试者的APD、FA和DCSA值在非轴向加压中立位下均低于轴向加压屈曲位(P<0.05),而高于加压伸展位(P<0.05)。L3/4,L4/5,L5/S1三个节段的EA,无论是否进行轴向负荷加载,屈曲位下值均小于仰伸位值(P<0.05)。计算三个节段ROM发现,无论是否进行轴向加压,L4/5的ROM均高于L3/4和L5/S1(P<0.05)。总体而言,非轴向加压下ROM值,低于轴向加压下ROM值(P<0.05)。所有受试者的EA,无论是否加载轴向负荷,均与相应的APD、FA和DCSA具有强相关性(r>0.6,P<0.05)。结论 相较于传统MRI,AL-P MRI可能更有助于腰椎疾病的诊断。
Objective To investigate the application of axial loaded positional MRI(AL-P MRI) in lumbar spine. Methods Six healthy adults were recruited for AL-P MRI examination in this study. The anteroposterior diameter(APD), foraminal area(FA), dural sac cross-sectional area(DCSA) and endplate angle(EA) values of 3 segments(L3/4, L4/5, L5/S1) in non-axial loaded neutral position, non-axial loaded flexion position, non-axial loaded extension position, axial loaded neutral position, axial loaded flexion position and axial loaded extension position were recorded and analyzed. Results APD, FA and DCSA values in non-axial loaded neutral position were lower than those in the axial loaded extension position(P<0.05) and higher than those in the axial loaded flexion position(P<0.05) in all subjects. The EA of three segments, L3/4, L4/5, L5/S1, were all lower in the flexion position than those in the extension position with or without axial loading(P<0.05). The ROM in L4/5was higher than that in L3/4and L5/S1with or without axial loading(P<0.05). Overall, the ROM values under non-axial loading were lower than those under axial loading(P<0.05). EA in all subjects, with or without axial loading, was closely correlated with the corresponding APD, FA and DCSA(r>0.6,P<0.05). Conclusion Compared to conventional MRI, AL-P MRI may be better in the diagnosis of lumbar spine disorders.
作者
张谨
潘杰
戴工华
杨蕾
张忠民
李雪松
沈彬
ZHANG Jin;PAN Jie;DAI Gonghua;YANG Lei;ZHANG Zhongmin;LI Xuesong;SHEN Bin(Department of Bone and Soft Tissue,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300202,China;Department of Spine Surgery,Shanghai East Hospital,School of Medicine,Tongji University,Shanghai 200120,China;Department of Neurosurgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)
出处
《同济大学学报（医学版）》
CAS
2023年第1期62-69,共8页
Journal of Tongji University(Medical Science)
基金
上海市卫健委临床专项课题(201940283)
江西省卫生健康委科技计划(SKJP220218218)。
