腰椎过伸位MRI在腰椎管狭窄诊断中的临床应用

目的：通过腰椎过伸位MRI检查，研究腰椎过伸位下椎管狭窄程度的变化，评估腰椎过伸位MRI扫描对腰椎管狭窄的诊断价值。方法：2018年9月至2020年2月，纳入26例腰椎管狭窄进行腰椎中立位和过伸位MRI扫描，男11例，女15例；年龄43~85（64.00±10.37）岁。由于6例患者在过伸位下诱发并加重了腰腿痛症状，无法采集到合格的MRI数据，最终完成检查共采集到20例患者的合格数据，采用Mimics 21.0医学图像处理软件测量腰椎管狭窄的相关诊断参数，统计分析其变化规律，评价过伸位下腰椎管的狭窄程度和神经受压情况。结果：腰椎管矢径及横截面积不随体位发生明显变化；硬膜囊矢径、盘黄间隙在过伸位时均有不同程度变小。结论：对于腰椎管狭窄的影像学诊断，腰椎过伸位MRI扫描可较好地补充常规中立位MRI检查，对腰椎管狭窄程度的临床诊断更具敏感性。

Clinical application of lumbar hyperextension MRI in the diagnosis of lumbar spinal stenosis

Objective: To evaluate the diagnostic value of lumbar hyperextension MRI, through studying the changes of spinal stenosis degree in lumbar hyperextension position.Methods: From September 2018 to February 2020, 26 patients with lumbar spinal stenosis did lumbar spine neutral and hyperextension MRI scans. There were 11 males and 15 females, aged from 43 to 85 (64.00±10.37) years. As 6 patients induced and aggravated the symptoms of low back and leg pain in the hyperextension position, qualified MRI data could not be collected. Because of that, a total of 20 patients'' qualified data were collected. Mimics Medical 21.0 medical image processing software was used to measure the relevant diagnostic parameters of lumbar spinal stenosis, analyze the change rules statistically, and evaluate the degree of lumbar spinal stenosis and changes in nerve compression in the hyperextension position.Results: The sagittal diameter and cross-sectional area of the lumbar spinal bony canal do not change significantly with the body position;the sagittal diameter of the dural sac, the sagittal diameter of the dural sac, and the disc yellow space all have different degrees of decline in the hyperextension position.Conclusion: For the imaging diagnosis of lumbar spinal stenosis, lumbar spine hyperextension position MRI can be a good complement for the routine neutral MRI examination, and it is more sensitive to the clinical diagnosis of lumbar spinal stenosis.