磁共振PROSET序列在腰脊神经根成像中的临床应用价值

目的：探讨磁共振选择性激励技术（PROSET）序列对腰脊神经根显示及病变诊断的价值。方法：用3.0T超高场MRI仪,对健康对照组70例及病例组43例行腰椎MRI常规序列（T1WI、T2WI）、PROSET序列及磁共振脊髓造影（MRM）序列扫描,PROSET用＂肥皂泡＂软件行神经根曲面容积重组,MRM行MIP重组。由2位教授级MRI诊断医师分析和比较3种方法显示腰脊神经根长度及病变的影像表现,评价PROSET的应用价值。结果：2位MRI诊断医师达成一致意见的结果,即PROSET显示腰脊神经根长度达节后段,MRM未显示节后段,差异有统计学意义（P〈0.05）。PROSET与常规MRI诊断腰椎间盘突出（LDH）差异无统计学意义,但PROSET显示神经根鞘受压移位、神经根病变及与神经根关系的全貌。＂Soap Bubble＂后处理PROSET图像在一帧图像上显示神经根走形全貌。结论：PROSET序列能诊断神经根病变,且图像质量优于MRM,是常规MRI的重要补充;＂Soap Bubble＂后处理图像可提供直观的解剖形态信息。

Application value of MR PROSET sequence in lumbar spinal nerve roots

Objective：To study the value of PROSET in the demonstration of lumbar spinal nerve root and the diagnosis of the disease.Methods：70 normal volunteers and 43 patients underwent lumbar spinal MRI in routine sequences （T2WI、T1WI）,PROSET and MRM on 3.0T MR scanner.＂Soap Bubble＂ software was used in PROSET images and MIP was used in MRM images.Two MRI diagnosticians （at professorship level） analysed and compared the imaging features of the three methods in showing the length and lesions of nerve root.Results：The length of nerve root shown in PROSET was longer than that in MRM （P〈0.05）,MRM did not show pro-ganglion.There was no significant difference of diagnosing LDH in PROSET and MRI,but PROSET could show compression and displacement of nerve root sheath,lesions of nerve roots and the neighbouring structures.The whole course of lumbar nerve root was shown on a single ＂soap bubble＂ image.Conclusion：PROSET is an important supplementary sequence of routine MRI since it is superior than MRM in diagnosing lumbar nerve root disease.＂Soap bubble＂ post-process image can offer visual anatomy information.