放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2015年
8期
826-830
,共5页
磁共振成像%扩散张量成像%表观扩散系数%脊髓损伤
磁共振成像%擴散張量成像%錶觀擴散繫數%脊髓損傷
자공진성상%확산장량성상%표관확산계수%척수손상
Magnetic resonance imaging%Diffusion tensor imaging%Apparent diffusion coefficient%Spinal cord inj u-ry
目的：探讨磁共振扩散张量成像（DTI）在急性颈髓外伤中的临床应用价值。方法：41例急性颈髓外伤（外伤后3天内）患者行常规MRI、DTI和扩散张量纤维束成像（DTT）检查。41例患者按照常规T2 WI上有无异常信号，分为阳性组（17例）和阴性组（24例）；选取年龄、性别相匹配的15例健康人作为对照组。分析各组中表观扩散系数（ADC）、各向异性分数（FA）、平行于颈髓长轴、前后径和左右径的本征值（λ1、λ2、λ3）的变化。结果：与对照组比较，颈髓外伤患者的FA值均降低，T2 WI阳性组中ADC、λ2、λ3均增高，而T2 WI阴性组中λ3值升高，差异均有统计学意义（P＜0．05）。与T2 WI阴性组比较，阳性组中λ3值较高，FA值较低，差异有统计学意义（P＜0．05）。DTT图显示颈髓损伤处神经纤维有不同程度的稀疏、移位、扭曲及断裂等征象。结论：FA、λ3值是检测颈髓外伤早期颈髓微结构改变的敏感指标，纤维束图能直观显示纤维束的细微变化情况。
目的：探討磁共振擴散張量成像（DTI）在急性頸髓外傷中的臨床應用價值。方法：41例急性頸髓外傷（外傷後3天內）患者行常規MRI、DTI和擴散張量纖維束成像（DTT）檢查。41例患者按照常規T2 WI上有無異常信號，分為暘性組（17例）和陰性組（24例）；選取年齡、性彆相匹配的15例健康人作為對照組。分析各組中錶觀擴散繫數（ADC）、各嚮異性分數（FA）、平行于頸髓長軸、前後徑和左右徑的本徵值（λ1、λ2、λ3）的變化。結果：與對照組比較，頸髓外傷患者的FA值均降低，T2 WI暘性組中ADC、λ2、λ3均增高，而T2 WI陰性組中λ3值升高，差異均有統計學意義（P＜0．05）。與T2 WI陰性組比較，暘性組中λ3值較高，FA值較低，差異有統計學意義（P＜0．05）。DTT圖顯示頸髓損傷處神經纖維有不同程度的稀疏、移位、扭麯及斷裂等徵象。結論：FA、λ3值是檢測頸髓外傷早期頸髓微結構改變的敏感指標，纖維束圖能直觀顯示纖維束的細微變化情況。
목적：탐토자공진확산장량성상（DTI）재급성경수외상중적림상응용개치。방법：41례급성경수외상（외상후3천내）환자행상규MRI、DTI화확산장량섬유속성상（DTT）검사。41례환자안조상규T2 WI상유무이상신호，분위양성조（17례）화음성조（24례）；선취년령、성별상필배적15례건강인작위대조조。분석각조중표관확산계수（ADC）、각향이성분수（FA）、평행우경수장축、전후경화좌우경적본정치（λ1、λ2、λ3）적변화。결과：여대조조비교，경수외상환자적FA치균강저，T2 WI양성조중ADC、λ2、λ3균증고，이T2 WI음성조중λ3치승고，차이균유통계학의의（P＜0．05）。여T2 WI음성조비교，양성조중λ3치교고，FA치교저，차이유통계학의의（P＜0．05）。DTT도현시경수손상처신경섬유유불동정도적희소、이위、뉴곡급단렬등정상。결론：FA、λ3치시검측경수외상조기경수미결구개변적민감지표，섬유속도능직관현시섬유속적세미변화정황。
Objective:To investigate the clinical application value of MR diffusion tensor imaging (DTI)in acute cer-vical spinal cord trauma.Methods:41 patient with acute cervical spinal cord trauma within three days after the trauma under-went conventional MRI and DTI examination.All the subjects were divided into positive group (n= 17)and negative group (n= 24),according to the conventional T2-weighted imaging.In addition,15 healthy volunteers were recruited as the control group with the matched age and sex.ADC,FA,λ1 ,λ2 andλ3 values were then calculated,and the fiber tracking of the cervi-cal cords was obtained.Results:Compared with the control group,FA value was significantly decreased in the patients with the cervical spinal cord trauma;the values of ADC,λ1 andλ2 were significantly increased in the T2-weighted positive group of the cervical spinal cord trauma;λ3 value was significantly increased in the T2-weighted negative group (all P<0.05). Compared with the T2-weighted negative group,the T2-weighted positive group had significantly higherλ3 value and lower FA value (both P<0.05).Diffusion tensor tractography (DTT)images demonstrated the different degrees of displace-ment,porosis,distortion and brack of the fibers of the injured cervical spinal cords.Conclusion:Both FA andλ3 value are sensitive indicators in detecting the subtle changes of the microstructures in the early stage of the cervical spinal cord trau-ma.The fiber tracking can visually display the subtle changes of the nerve fibers.
