PROSET序列对腰骶神经根变异的诊断价值

目的观察和探讨PROSET序列对腰骶部神经根变异(LSNRA)的诊断价值及其相应影像表现。方法采用常规MRI序列和3DPROSET序列扫描108例腰腿痛患者,所得PROSET序列图像均行3DMIP后处理;结合原始图像及3DMIP图像观察双侧腰骶神经根的分布情况。结果该组病例中有105例的图像达到诊断要求,图像优良率为97.22%;常规MRI序列和PROSET序列各发现LSNRA3例和14例,显示率分别为2.86%、13.33%,两者存在显著差异(x2=6.367,P=0.007);在14例变异中,Ⅱ型变异为10例,占71.43%;其中Ⅱ-1型4例,占28.57%;Ⅱ-2、Ⅱ-3、Ⅱ-4型各2例,各占14.29%;Ⅲ型及Ⅵ型变异各2例,亦各占14.29%。结论PROSET序列清晰、直观地显示硬膜囊外腰骶神经根的走行及形态;为硬膜外腰骶神经根变异的诊断提供了一种全新的方法。     

MR-PROSET序列观察腰骶神经根(节)解剖

目的评价磁共振选择性水激励脂肪抑制技术(MR-PROSET)在显示腰骶神经(节)中的价值。方法采用3DPROSET序列扫描健康受试者30例,所得原始图像行3DMIP后处理,结合原始图像及MIP图像观察腰骶神经根(节)的形态和走行,并测量相关解剖数据。结果PROSET序列图像能清晰显示L1～S1水平的神经根鞘、神经节以及L3～S1水平的节外段神经;L1～2水平的节外段显示稍差。L1～L5水平的神经根鞘长度逐渐增加,而S1水平的神经根鞘长度较L5水平稍短。L1～S1水平的神经根鞘直径、神经节长径、宽径以及面积均自上而下逐渐增加;神经根鞘倾斜角则自上而下逐渐减小。结论MR-PROSET序列能清晰显示腰骶神经根(节)的解剖形态。     

下肢节段性神经根刺激H反射在腰骶神经根病诊断中的意义

目的：探讨节段性神经根刺激Ｈ反射（ＮＲＳＨ）在腰骶神经根病诊断中的意义，方法：采用高压短脉电刺激直接激腰骶神经根，在比目鱼肌及半腱肌记录Ｈ反射，共检测正常人６０例Ｓ１及Ｌ５神经根病患者各３０例，结果：（１）ＮＲＳＨ诊断腰骶神经根病的阳性率，比目鱼肌ＮＲＳＨ在Ｓ１神经根病为１００％，半腱肌ＮＲＳＨ在Ｌ５神经根病为９６．７％；（２）ＮＲＳＨ各指标中，据Ｈ－Ｍ间期两侧差，比目鱼肌ＮＲＳＨ在Ｓ１神经根病诊     

三维脂肪抑制平衡式非稳态自由进动序列在腰骶神经根病变中的应用

目的探讨1.5T PHILIPS磁共振扫描仪三维脂肪抑制平衡式非稳态自由进动(3D FS-balanced-nSSFP)序列在腰骶脊神经根病变中的临床应用价值。方法 80例不同程度的腰腿痛患者在1.5T PHILIPS磁共振扫描仪行3D FS-balanced-nSSFP序列检查,并用3D最大强度投影重组(MIP)做后处理。结果 80例受检者中,腰骶脊神经根正常者21例,腰骶脊神经根病变患者59例,其中椎间盘突出症患者45例,骶神经根周围囊肿9例,腰椎结核1例,肿瘤4例。3D FS-balanced-nSSFP序列能清楚显示病变对神经根侵犯和压迫程度。结论 3D FS-balanced-nSSFP序列可较好地评价腰骶脊神经根病变,并结合常规MR扫描,有利于临床诊治方案的制定。     

3D-SPACE与3D-MEDIC序列神经成像对腰骶丛显示的对比研究

目的探讨3D-SPACE与3D-MEDIC序列神经成像对腰骶丛的显示效果。方法选取行腰骶部或盆腔MRI检查的健康志愿者86例,均行常规腰椎磁共振(MRI)、3D-SPACE与3D-MEDIC序列扫描,计算2种序列的_(神经根)信噪比值(SNR_(神经根))、肌肉信噪比值(SNR_(肌肉))、神经根和肌肉的对比度噪声比值(CNR_(神经根/肌肉))及图像质量评分。结果 3DMEDIC序列的SNR_(神经根)、SNR_(肌肉)、CNR_(神经根/肌肉)明显高于3D-SPACE序列(P0.05),各部位图像质量评分均明显高于3D-SPACE序列(P0.05)。结论相较于3D-SPACE序列,3D-MEDIC序列能更清晰显示腰骶神经丛的解剖形态,是常规腰椎MRI的重要补充。     

3D-STIR磁共振序列诊断神经根型颈椎病的临床价值

目的 探讨三维反转恢复快速自旋回波（3D-STIR）序列在显示颈部节前神经根受压情况,以及颈椎间盘突出与颈部神经根关系的临床应用价值,并评估该技术在不同节段（C6神经根及C7神经根）的诊断价值。方法 收集2021年9月～2022年3月于牡丹江医学院附属红旗医院就诊的有颈部疼痛、上肢麻木等有神经根受压症状并且临床高度怀疑神经根型颈椎病的100例患者,分别行磁共振常规序列（矢状位T2WI、T1WI、STIR,轴位T2WI）、3D-STIR序列扫描以及结合两种扫描方式判断神经根是否受压,分别统计C5～7单侧单节段神经根传导功能障碍的患者有无神经根受压的影像学表现。3D-STIR序列所有图像采用3D最大信号强调投影与曲面重组等后处理,由2名中高级职称磁共振诊断医师通过对重建后图像显示的神经根形态、走行、受压情况以及椎间盘与神经根关系的影像表现,评价3D-STIR序列在诊断神经根型颈椎病的临床应用价值。结果 按C6/C7神经根是否受压分为两组,常规核磁平扫、3D-STIR序列以及常规核磁平扫与3D-STIR序列结合诊断结果显示,按C6神经根是否受压,得出一致性分别为0.578、0.758、0.8...     

3D-T2-FFE序列在腰骶丛神经成像中的应用

目的 探讨三维T2加权快速梯度回波（3D-T2-FFE）图像对显示腰骶丛神经的应用价值。方法 收集腰骶丛神经病变患者29例，行常规腰骶椎MRI后加扫3D-T2-FFE及MR选择性水激励脂肪抑制技术（MR-PROSET）序列成像。测量并计算2个序列图像的神经信噪比（SNR_神经）、肌肉SNR（SNR_肌肉）、对比噪声比（CNR_{神经/肌肉}），比较2个序列图像对腰骶丛神经病变的诊断效能。结果 所有病例3D-T2-FFE图像CNR（0.21±0.08）高于MR-PROSET图像（0.11±0.04，P<0.01），SNR_肌肉（66.99±24.62）低于MR-PROSET（108.92±42.28，P<0.01），SNR_神经（150.34±14.98）与MR-PROSET图像（138.02±11.17）差异无统计学意义（P>0.05）；3D-T2-FFE图像显示骶丛、股神经、闭孔神经的评分 （2.32±0.13、1.63±0.60、1.84±0.38）均高于MR-PROSET图像（1.95±0.14、0.11±0.32、1.16±0.38，P均<0.05），而腰丛、腰骶干、坐骨神经的评分（2.95±0.05、1.79±0.42、1.84±0.09）与MR-PROSET图像差异均无统计学意义（2.79±0.42、1.63±0.50、1.74±0.10，P均>0.05）。结论 3D-T2-FFE序列图像可有效评估腰骶丛神经病变，为临床提供更客观、准确的信息。     

3D-nerve序列对新生儿臂丛神经的成像效果

目的 与背景抑制DWI（DWIBS）、基于3D短T1反转恢复（3D-STIR）序列对比,探讨3D-nerve序列对新生儿臂丛神经的成像效果。方法 对15例臂丛神经损伤的新生儿行MR扫描,扫描序列包括3D-nerve、DWBIS、3D-STIR,评估每个序列图像的血管搏动伪影、脂肪抑制均匀性及臂丛神经分支的显示效果,并测量神经-脂肪比,神经-肌肉比。结果 臂丛神经在DWIBS序列图像上显示效果差,无法观察;3D-nerve血管搏动伪影和脂肪抑制不均匀与3D-STIR比较差异均无统计学意义（P均>0.05）。3D-nerve、3D-STIR对新生儿臂丛神经根、神经干的显示率均为100%（15/15）;3D nerve对神经束、神经支的显示率为100%（15/15）和66.67%（10/15）,3D-STIR对神经束、神经支的显示率为93.33%（14/15）和53.33%（8/15）,差异无统计学意义（P=1.00、0.71）。3D-nerve序列神经-脂肪比和神经-肌肉比优于3D-STIR序列,差异有统计学意义（P均<0.05）。结论 3D-nerve序列在新生儿臂丛神经损伤中的成像效果明显优于DWBIS及3D-STIR序列。     

3.0 T MRI 3种扫描序列对颈神经根成像的对比研究

目的比较3.0 T MRI 3种扫描序列对颈神经根成像的应用价值。材料与方法收集临床需要扫描颈椎MRI患者37例,均行常规序列、三维双回波稳态(three-dimensional double-echo steady state,3D-DESS)序列、多回波数据图像重合(multi-echo data image combination,MEDIC)序列、可变反转角三维快速自旋回波(3D sampling perfection with application optimized contrasts using different flip angle evolutions,3D-SPACE)序列扫描,所有图像均进行后处理重建,对图像质量和正常颈神经根显示、受压颈神经显示清晰度、颈神经根与邻近组织的对比噪声比(contrast noise ratio,CNR)3个方面进行评价。结果 3种扫描序列3个方面两两比较,3D-DESS序列神经根-椎体CNR和神经根-脑脊液CNR均高于MEDIC序列;3D-DESS序列神经根-椎体CNR高于3D-SPACE序列,而3D-DESS序列神经根-脑脊液CNR低于3D-SPACE序列;3D-SPACE序列神经根-脑脊液CNR高于MEDIC序列,3D-SPACE序列神经根-椎体CNR与MEDIC序列差异无统计学意义。图像质量评分3种序列两两对比差异均有统计学意义(P0.05),3D-DESS序列优于MEDIC序列,而3D-SPACE序列图像质量最差。对受压神经根清晰度的显示,3D-DESS序列和MEDIC序列差异无统计学意义,两序列与3D-SPACE序列对比,差异均有统计学意义(P0.05),即两序列均优于3D-SPACE序列。结论对于显示神经根结构和诊断神经根病变等方面,3D-DESS序列明显优于MEDIC序列和3D-SPACE序列,对颈神经根成像及颈神经根受压的临床诊断更具优势。     

创伤性臂丛神经损伤的磁共振成像3D-FIESTA-C、IDEAL序列特征及诊断价值

目的：探讨创伤性臂丛神经损伤的磁共振成像（MRI）三维循环相位稳态采集快速成像（three-dimensional fast imaging employing steady state acquisition with cycled phases,3D-FIESTA-C）序列和三点法非对称回波水脂分离成像（iterative decomposition of water and fat with echo asymmetry and least squares estimation,IDEAL）序列特征及诊断价值。方法：对32例创伤性臂丛神经损伤患者进行术前MRI 3D-FIESTA-C及IDEAL序列检查后,再行图像后处理及诊断,总结臂丛神经损伤的MRI特征,将诊断结果与手术探查结果进行比较,评价术前MRI 3D-FIESTA-C联合IDEAL序列检查在诊断臂丛神经损伤中的作用。结果：12例患者术后证实共有39条节前神经损伤,3D-FIESTA-C序列显示出38条,其中31条神经根影像提示消失或离断,7条神经根丝减少、迂曲,无法连续追踪至椎间孔,同时可伴有神经根袖变钝、脊膜囊肿形成、硬脊膜增厚及脊髓形态信号异常改变。术前MRI 3D-FIESTA-C序列诊断臂丛神经节前损伤的灵敏度为97.5%,特异度为100%,准确率达98.3%。31例120条节后损伤中共12例45条节后神经断裂,其中7条伴纤维瘤形成,IDEAL序列显示42条节后神经根断裂,其他损伤表现为神经增粗,扭曲,走行僵直,周围结构水肿紊乱等。术前IDEAL序列诊断臂丛节后损伤的灵敏度为96.7%,特异度为100%,准确率为97.1%。结论：MRI 3D-FIESTA-C联合IDEAL序列检查可清晰显示节前及节后臂丛神经损伤情况,对臂丛神经损伤的诊断符合率较高,可作为临床首选的无创性影像学方法。     

增强3D-Space-iso序列在全段脊神经根成像中的临床应用

目的：探讨3.0 T磁共振增强3D-Space-iso序列在全段脊神经根的显示及相应脊神经根病变的诊断价值。材料与方法搜集脊神经根病变患者15例,正常志愿者3例,进行常规MRI序列扫描,冠状位非增强及增强3D-Space-iso序列,后两者均用3D最大信号强度投影做重建后处理,观察各序列显示脊神经根形态、大小及长度、走行与病变的关系。结果增强3D-Space-iso显示脊神经根、神经节及节后纤维较非增强3D-Space-iso及常规序列有更高的清晰度,能更清晰显示脊神经根病变及病变对脊神经根的压迫及侵犯程度。15例患者中腰椎间盘突出10例,肿瘤性病变3例,神经根鞘囊肿2例。结论增强3D-Space-iso序列对显示脊神经根解剖结构、以及与病变的解剖关系具有更大的优势,为临床诊治脊神经根病变提供明确的诊断依据。     

腰骶神经根疾病核磁共振脊髓造影的影像学分析

AIM: To illustrate the magnetic resonance(MR) myelography features in the disease of lumbosacral nerve roots. METHODS: MR myelography using heavily T2 weighted spin-echo imaging with fat suppression was performed in 75 cases with chronic pain of waist on a Siemens Magneton Impect 1.0 T MR unit Maximum intensity projection (MIP) was used for image reconstruction. RESULTS: The thecal maugins, nerve roots and nerve root sheaths were well demonstrated on MR myelography image. In 75 patients with chronic of waist, nerve root disease was found in 11 cases. 6 nerve root abnormality (8% ), 2 perineural cyst (3% ), 3 neurofibroma (4% ) had their own MR myelography features. CONCLUSION: MR myelography can show the morphologic and structural change of lumbosacral nerve roots. In MR myelography image, disease of lumbosacral nerve roots has a characteristic finding. MR myelography is very useful in diagnosis of nerve-root disease.     

臂丛神经MRI正常表现及检查方案

目的分析正常臂丛神经在MRI不同成像序列中的表现,确定臂丛神经损伤时最佳MRI检查方案。方法20名正常志愿者行常规及MR新技术检查。观察各序列中臂丛神经的表现及显示情况。结果常规T1WI、T2WI臂丛神经呈等信号,STIR上呈高信号。冠状面T1WI、T2WI及STIR图像对比噪声比分别为：4.96±0.31、6.07±0.18、23.09±1.20,STIR图像对比噪声比明显高于常规组（P=0.000）;对节后段C5,6神经根及上干的显示评分STIR序列明显高于常规序列。3D-FIESTA-c序列清晰显示椎管内神经前后根,为脑脊液高信号环绕下的等信号丝状结构。3D-FSPGR图像可清晰显示臂丛与邻近组织结构的关系。结论联合常规及MRI新技术,可全面、清晰地显示臂丛神经,作为臂丛神经的常规检查方案。     

Magnetic resonance microimaging of the spinal cord in the SOD1 mouse model of amyotrophic lateral sclerosis detects motor nerve root degeneration

Amyotrophic lateral sclerosis (ALS) is characterized by selective degeneration of motor neurons. Current imaging studies have concentrated on areas of the brain and spinal cord that contain mixed populations of sensory and motor neurons. In this study, ex vivo magnetic resonance microimaging (MRM) was used to separate motor and sensory components by visualizing individual dorsal and ventral roots in fixed spinal cords. MRM at 15μm in plane resolution enabled the axons of pure populations of sensory and motor neurons to be measured in the lumbar region of the SOD1 mouse model of ALS. MRM signal intensity increased by 38.3% (p<0.05) exclusively in the ventral motor nerve roots of the lumbar spinal cord of ALS-affected SOD1 mice compared to wildtype littermates. The hyperintensity was therefore limited to white matter tracts arising from the motor neurons, whereas sensory white matter fibers were unchanged. Significant decreases in ventral nerve root volume were also detected in the SOD1 mice, which correlated with the axonal degeneration observed by microscopy. These results demonstrate the usefulness of MRM in visualizing the ultrastructure of the mouse spinal cord. The detailed 3D anatomy allowed the processes of pure populations of sensory and motor neurons to be compared.     

平衡式稳态自由进动序列成像正常椎管内臂丛神经根解剖研究

目的：应用MRI平衡式稳态自由进动（Balance SSFP）序列成像多平面重建描述椎管内臂丛正常形态解剖。材料与方法：本组20例自愿者行MRI检查;从283例同时行CTM和MRI检查中筛选CTM未见椎管内臂丛神经根结构损伤的28例与MRI比较。行冠状、矢状及斜横轴位重建,测量20例自愿者各组神经根。结果：冠状图像显示完整的神经前、后根结构,前根表现为“机翼状”,后根表现为“毛刷状”;矢状位脊髓旁层面显示各组神经根与相应椎体位置关系;斜横轴位图像显示神经根连续性更完整,避免了上下组神经根重叠。结论：应用Balance-SSFP序列成像,冠状位、矢状位及斜横轴位重建图像,可提供更多的椎管内臂丛的形态解剖学信息。     

Intrathecal movement and tension of the lumbosacral roots induced by straight-leg raising

OBJECTIVE: To obtain quantitative biomechanical data on the effects of different angles of straight-leg raising on intrathecal movements and tensions in the lumbosacral nerve roots in human cadavers. DESIGN: Eight embalmed human cadavers with no gross spinal pathology and no limitations in hip motion were used. We performed reverse straight-leg raising by hanging the left leg down from the table with the knee extended while measuring the movement and tension of nerve roots L2, L3, L4, L5, and S1 in 10-degree intervals for straight-leg raising from 0 to 70 degrees. RESULTS: The mean intrathecal movements at 70 degrees were 0.55 mm, 0.54 mm, 0.96 mm, 1.54 mm, and 2.31 mm for roots L2, L3, L4, L5, and S1, respectively. The movements were statistically significant at >50 degrees for root L5 and at >40 degrees for root S1 (P < 0.05). The tension in the nerve roots with increasing angle of straight-leg raising increased from roots L2 to S1. The mean tensions at 70 degrees of straight-leg raising were 141.25 g, 168.75 g, 228.75 g, 280.00 g, and 493.75 g for roots L2, L3, L4, L5, and S1, respectively. The difference in tension was significant at >70 degrees for roots L2, L3, and L4 roots, at >40 degrees for root L5 root, and at >10 degrees for root S1 (P < 0.05). CONCLUSIONS: The intrathecal movement and tension of the lumbosacral roots induced by straight-leg raising were <2.5 mm and <500 g, respectively. The movement and tension induced by straight-leg raising tended to be greater in more distal segmental roots.     

Magnetic Resonance Microscopy of the C57BL Mouse Brain

With the rapid progression in gene technologies, transgenic, targeted, and chemically induced mutations in mice are continually created. The major goal of these studies is to understand and characterize the effects of genotype on anatomy, physiology, and behavior and ultimately the role of genotype in development of disease. The demand for imaging techniques with high spatial resolution potential is rising because such imaging tools would expedite anatomical phenotyping in the genetically altered mice. Magnetic resonance microscopy (MRM) is a noninvasive, inherently three-dimensional (3D) imaging technique capable of visualizing several anatomical structures in the small mouse. The 3D nature of MRM also allows for interpretation of complex spatial relationships between substructures, which is important when phenotyping anatomically. The goal of this paper is to systematically describe three major brain regions in the C57BL/6J mouse at microanatomical spatial resolution ranges using in vitro MRM. We explore different MR contrast parameters, voxel sizes, and signal-to-noise ratios to best characterize C57BL/6J mouse brain microstructure by MRM. Further, we compare all MRM images with Nissl-stained brain sections. Major findings were as follows: T2* MR images visualized several gross anatomical regions in the mouse brain but not, for example, subregions within the hippocampus. Diffusion proton stains on the other hand were superior to T2* MR images and delineated many subregions within the hippocampus proper. Finally, contrast enhancement facilitated visualization of hippocampal anatomy on the T2* MR images. The results of this study are part of an ongoing initiative at our Center focused on creating a complete C57BL/6J mouse anatomical 3D image database by MRM.