3D DESS磁共振序列诊断神经根型颈椎病临床价值

目的：探讨3D双回波稳态进动（dual echo steady state ，DESS）磁共振序列在显示椎管内臂丛神经的形态解剖学信息的情况，以及在显示突出椎间盘与椎管内臂丛神经的关系的临床应用价值。方法对35例有颈肩痛和上肢麻痛等颈丛和臂丛神经根受压症状，临床高度怀疑神经根型颈椎病患者行颈椎M RI常规序列（矢状位 T1 WI ，T2 WI ，横轴位T2WI）和3D DESS序列，3D DESS序列的所有图像均采用3D最大信号强度投影（MIP）与曲面重组等后处理，由2位高级职称M RI影像诊断医师通过对重建后图像所显示的臂丛神经椎管内神经根的形态、长度以及突出椎间盘与椎管内臂丛神经的关系的影像表现，评价3D DESS序列在神经根型颈椎病影像诊断中的临床应用价值。结果3D DESS序列重建图像和常规MRI T2WI序列图像对臂丛神经椎管内神经前根的显示率分别为94．3％（33／35）和88．6％（31／35），对臂丛神经椎管内神经后根的显示率分别为94．3％（33／35）和80％（28／35），3D DESS序列明显优于常规层厚 T2 WI图像，差异有显著性意义（P ＜0．05）；在臂丛神经椎管内神经前后根完整性的显示方面，两者间差异无统计学意义（P ＞0.05）。结论3D DESS序列经重建后的图像，可提供更多的椎管内臂丛神经的形态解剖学信息，能清晰显示突出椎间盘对神经根的压迫情况，为临床治疗提供明确依据。

Clincal value of 3D DESS MRI sequences in the diagnosis and treatment of cervical spondylosis of nerve root type

Objective To investigate the 3D double‐echo steady‐state precession （dual echo steady state ,DESS） magnet‐ic resonance sequences in displaying the anatomical information of the brachial plexus in spinal canal as well as to explore its clinical value in displaying the relationship betweem the herniated disc and spinal brachial plexus .Methods 35 pa‐tients ,who presented with neck pain ,upper limb numbness ,and other symptoms of neck and brachial plexus nerve root compression and were highly suspected to be associated with cervical spondylosis of nerve root type in clinic ,were subjec‐ted to conventional MRI sequences （sagittal T1WI ,T2WI ,horizontal position T2WI） and 3D DESS sequence .All images from 3D DESS sequences were post‐processed using 3D maximum intensity projection （MIP） and surface recombination . Then ,in line with imaging manifestations of the morphology and length of spinal nerve roots of brachial plexus in spinal canal and the relationship between the herniated disc and spinal brachial plexus displayed in the reconstruction images ,two senior physicians evaluated the clincal value of 3D DESS MRI sequences in the diagnosis of cervical spondylosis of nerve root type .Results The rates of the ventral roots of brachial plexus in spinal canal displayed by 3D DESS sequence recon‐structed image and conventional MRI T2WI sequence were 94 .3% （33/35） and 88 .6% （31/35） ,respectively ,while ,the rates of dorsal roots by those two modalities were 94 .3% （33/35） and 80% （28/35） .3D DESS sequence was superior to conventional thickness T2 WI images ,with significant difference significant （ P 〈0 .05） .However ,there was no differ‐ence in displaying the integrity of the ventral roots and dorsal roots of brachial plexus in spinal canal with these two meth‐ods （ P 〉 0 .05） .Conclusion The reconstructed images from 3D DESS sequence can provide more information on mor‐phology and anatomy of brachial plexus in spinal canal ,clearly show the compressive situat