CAJ | 학술논문

目的运用MR扩散张量成像(DTI)定量研究正常青年人腰骶神丛神经的各向异性特点及扩散张量示踪成像(DTT)技术显示腰骶丛神经.方法收集60名健康志愿者(男30名,女30名)行腰骶丛神经DTI.测量双侧腰3(L3)至骶1(S1)神经根各部位(椎间孔内外侧)各向异性分数(FA)值,同时进行双侧腰3至骶1神经根DTT研究.L3至S1不同节段神经根FA值使用ANOVA方差分析,两两比较采用采用SNK法检验.L3至S1各节段神经根左右侧及椎间孔内外侧FA值采用配对t检验.结果 (1)L3至S1节段神经根FA值分别为0.212±0.030、0.225±0.035、0.203±0.030和0.187±0.019,各段神经根FA值差异有统计学意义(F=70.457,P＜0.01),任意两节段神经根FA值差异均有统计学意义(SNK法两两比较,P值均＜0.05).(2)L3至S1节段左侧椎间孔内侧FA值分别为0.202±0.021、0.201±0.026、0.203±0.027、0.191±0.016,外侧分别为0.222±0.034、0.250±0.028、0.203±0.026、0.183±0.020；右侧椎间孔内侧FA值分别为0.200±0.023、0.202±0.023、0.205±0.027、0.191±0.017,外侧分别为0.225±0.032、0.247±0.027、0.205±0.033、0.183±0.021.L3、L4、S1节段椎间孔内外侧神经根FA值差异有统计学意义(t值为-9.114～2.366,P值均＜0.05),L5节段椎间孔内外侧神经根FA值差异无统计学意义(P值均＞0.05).L3至S1相同节段两侧腰骶丛神经FA值差异均无统计学意义(P值均＞0.05).(3)利用DTT可以连续完整地重建显示L3至S1神经根神经纤维束.结论应用DTI及DTT技术可以定量描述腰骶丛神经的扩散特征及有效直观重建显示腰骶丛神经,可为诊断腰骶丛神经病变提供新的定量观察指标.
목적 운용MR확산장량성상(DTI)정량연구정상청년인요저신총신경적각향이성특점급확산장량시종성상(DTT)기술현시요저총신경.방법 수집60명건강지원자(남30명,녀30명)행요저총신경DTI.측량쌍측요3(L3)지저1(S1)신경근각부위(추간공내외측)각향이성분수(FA)치,동시진행쌍측요3지저1신경근DTT연구.L3지S1불동절단신경근FA치사용ANOVA방차분석,량량비교채용채용SNK법검험.L3지S1각절단신경근좌우측급추간공내외측FA치채용배대t검험.결과 (1)L3지S1절단신경근FA치분별위0.212±0.030、0.225±0.035、0.203±0.030화0.187±0.019,각단신경근FA치차이유통계학의의(F=70.457,P＜0.01),임의량절단신경근FA치차이균유통계학의의(SNK법량량비교,P치균＜0.05).(2)L3지S1절단좌측추간공내측FA치분별위0.202±0.021、0.201±0.026、0.203±0.027、0.191±0.016,외측분별위0.222±0.034、0.250±0.028、0.203±0.026、0.183±0.020；우측추간공내측FA치분별위0.200±0.023、0.202±0.023、0.205±0.027、0.191±0.017,외측분별위0.225±0.032、0.247±0.027、0.205±0.033、0.183±0.021.L3、L4、S1절단추간공내외측신경근FA치차이유통계학의의(t치위-9.114～2.366,P치균＜0.05),L5절단추간공내외측신경근FA치차이무통계학의의(P치균＞0.05).L3지S1상동절단량측요저총신경FA치차이균무통계학의의(P치균＞0.05).(3)이용DTT가이련속완정지중건현시L3지S1신경근신경섬유속.결론 응용DTI급DTT기술가이정량묘술요저총신경적확산특정급유효직관중건현시요저총신경,가위진단요저총신경병변제공신적정량관찰지표.
Objective To observe the lumbosacral plexus nerves by diffusion tensor tractography (DTT) and quantitatively evaluate them by using diffusion tensor imaging (DTI) in healthy volunteers.Methods A total of 60 healthy volunteers (30 males and 30 females) underwent DTI scanning.Mean FA values of the lumbosacral plexus nerves (both sides of lumbar roots L3 to S1,proximal and distal to the lumbar foraminal zone) were quantified.Differences among various segments of lumbar nerve roots were compared with ANOVA test and SNK test.Differences between two sides of the lumbar nerve roots at the same lumbar segment were compared with paired-samples t test.Differences between the proximal and the distal nerve to the the lumbar foraminal zone at the same lumbar segment were compared with paired-samples t test.The lumbosacral plexus nerve was visualized with tractography.Results (1) The lumbosacral plexus nerve was clearly visualized with tractography.(2) Mean FA values of the lumbar nerve roots L3 to S1 were as followings:proximal to the left lumbar foraminal zone 0.202 ± 0.021,0.201 ± 0.026,0.201 ± 0.027,0.191 ±0.016,distal to the left lumbar foraminal zone 0.222 ± 0.034,0.250 ± 0.028,0.203 ± 0.026,0.183 ± 0.020,proximal to the right lumbar foraminal zone 0.200 ± 0.023,0.202 ± 0.023,0.205 ± 0.027,0.191 ±0.017,distal to the right lumbar foraminal zone 0.225 ±0.032,0.247 ±0.027,0.205 ± 0.033,0.183 ±0.021.Mean FA values were significantly different between the proximal nerve to the distal nerve in lumbar nerve roots L3,L4,S1 (t =-9.114-2.366,P ＜ 0.05),but not significantly different in L5 (P ＞ 0.05).Differences were not found between the right and left side nerves at the same lumbar segment (P ＞ 0.05).(3) The whole length of the lumbar roots nerve L3 to S1 can be visualized clearly by using DTT.Conclusions Diffusion tensor imaging and tractography can show and provide quantitative information of human lumbosacral plexus nerves.DTI is a potential tool for the diagnosis of lumbosacral plexus nerve disease.