扩散加权神经成像在腰骶丛神经影像诊断的临床应用

目的 探讨扩散加权磁共振神经成像(DW-MRN)和选择性水激励脂肪抑制技术(PROSET)腰骶丛神经成像特点及其临床应用价值.资料与方法 对25例腰骶部受检者行常规MRI、PROSET及DW-MRN.结果 PROSET对腰骶丛神经显示率达100%,对腰丛神经显示效果好于DW-MRN,差异有统计学意义(χ~2=6.300,P<0.05),对腰骶干和骶神经的显示效果亦好于DW-MRN,但差异无明显统计学意义(χ~2=5.922,P>0.05;χ~2=3.870,P>0.05).PROSET能清晰显示腰骶神经根和根鞘,对神经根病变显示良好.DW-MRN对腰骶从神经受累增粗和信号增高较敏感,最大密度投影(MIP)重组的3D图像可清晰显示腰骶丛节后神经.结论 DW-MRN可立体、直观地显示腰骶丛神经节及节后神经.PROSET与DW-MRN结合,能使腰骶丛神经病变在精确成像下直观诊断.

Clinical Application of Diffusion Weighted Magnetic Resonance Neurography in Lumbosacral Plexus

Objective To approach imaging characteristic and clinical diagnosis value of PROSET and DW-MRN in lumbosacral plexus. Materials and Methods 25 cases were performed lumbosacral MR exam, including PROSET and DW-MRN. Results PROSET could demonstrate lumbosacral plexus clearly with 100% ratio of detection. The display effect for lumbar plexus on PROSET was better than that on DWMRN (χ~2 = 6.300, P < 0.05), and the same effect for lumbosacral trunk and sacral nerve, but the difference between PROSET and DWMRN had no statistically significant (χ~2= 5.922 ,P > 0.05 ;χ~2 = 3.870,P >0.05). DWMRN was sensitive to nerve thickening and signal intensity increased. Constructive 3D image of DWMRN could clearly manifest post-ganglion segment of lumbosacrai plexus. Conclusion DWMRN can directly show the ganglion and post-ganglion segment. Combination PROSET and DWMRN could diagnosis lumbosacral plexus neuropathy by direct-viewing.