牵引治疗对颈椎病患者椎间盘MR扩散特点的影响

目的:观察牵引治疗后颈椎病患者椎间盘ADC值和FA值的变化,探讨DTI对颈椎病牵引治疗疗效评估的价值。方法:颈椎病患者60例均行牵引治疗,牵引重量为体重的5%～15%,牵引时间为20min,每天1次,疗程10天,牵引治疗前后行DTI检查。利用DTI原始数据重组ADC图、FA图,测定牵引治疗前后椎间盘的ADC值、FA值,分析牵引治疗后ADC值、FA值的变化。椎间盘牵引治疗前后ADC值和FA值的比较采用配对t检验。结果:60例患者360个椎间盘中,轻度退变椎间盘143个,中度退变椎间盘125个,重度退变椎间盘92个。轻度退变椎间盘、中度退变椎间盘治疗前ADC值、FA值的平均值分别为8.36×10-4 mm2/s和0.72×10-4、7.66×10-4 mm2/s和0.65×10-4,牵引治疗后ADC值和FA值的平均值分别增加了0.65×10-4 mm2/s和0.09×10-4、0.74×10-4 mm2/s和0.07×10-4,牵引治疗前后椎间盘ADC值及FA值之间差异有统计学意义(P<0.05)。重度退变椎间盘治疗前ADC值、FA值的平均值分别为7.19×10-4 mm2/s和0.53×10-4,牵引治疗后ADC值和FA值的平均值分别增加了0.15×10-4 mm2/s和0.03×10-4,治疗前后椎间盘ADC值及FA值之间差异无统计学意义(P>0.05)。结论:牵引治疗可增加轻、中度退变椎间盘的ADC值及FA值,即增加其扩散能力,而对重度退变椎间盘的扩散能力无影响。

Influence of traction therapy on MR diffusion characteristics of the intervertebral discs in patients with cervical spondylosis

Objective：To observe the ADC and FA changes in traction treated cervical spondylosis patients and to assess the value of DTI.Methods：Sixty patients（aged 25~55 years） with cervical spondylosis underwent cervical spine MRI and diffusion tensor imaging（DTI）.After a course of traction treatment（with 5% to 15% body weight for 20 minutes per day,10 days）,a repeat DTI was performed.DTI were obtained by using an echo planar imaging（EPI） sequence（TE 89ms,TR 2500ms,b value of 800s/mm2,11 noncollinear diffusion directions）.Scan time was approximately 8min20s.The mean ADC value and FA value prior to and following traction treatment were analyzed with t test and Rank Sum teal.Results：No significant difference was found in mean ADC and FA of the intraclass for Grade 0~6.Significant difference was observed in mean ADC and FA of the intraclass for Grade 7~8.The ADC values of grade prior to and following traction treatment were（8.65±0.46）×10-4mm2/s and（9.32±0.52）×10-4mm2/s,The ADC values of grade 8 prior to and following traction treatment were（7.10±0.51）×10-4mm2/s and（7.25±0.57）×10-4mm2/s.Conclusions：Traction treatment mainly affect the ADC and FA value of normal,slightly and moderately degenerated discs.The ADC value increases and the diffusion ability of the disc increases.No obvious ADC and FA values changes were observed in the severely degenerated discs.