MR弥散张量成像在脊柱脊髓疾病诊断中应用的研究进展

目的 探讨MR弥散张量成像(DTI)在脊髓疾病诊断中的应用进展。方法 在PubMed、Springer Link、中国知网数据库中,以“弥散张量成像、脊髓疾病、椎间盘”关键词,查阅2003年1月—2014年12月有关MR-DTI在脊髓疾病应用进展的相关文献,进行分析和总结。结果 MR-DTI体现脊髓病变早期组织空间组成和各组织成分之间水交换功能的改变,并能显示神经纤维束的走行方向,反映脊髓束功能的完整性。MR-DTI已逐渐应用于脊髓型颈椎病的早期诊断、脊髓损伤时期的判断和腰骶椎神经根病变的诊断以及腰椎间盘退变的早期诊断。DTI应用于脊髓疾病的诊断时,由于存在脊髓体积过小、扫描时间过长、运动伪影等不足,阻碍其在脊髓疾病诊断领域的发展。目前,随着并行成像技术、单次激发快速自旋回波序列等新技术的应用,这些问题正在逐步得到解决。结论DTI已在脊柱脊髓领域发挥出常规MR检查不可替代的作用。随着影像学的进步、新技术的应用及经验的丰富,DTI应用存在的阻碍必将得到解决,DTI在脊髓疾病领域的应用具有广阔的前景。

Application progress of MR diffusion tensor imaging in the diagnosis of spine and spinal cord diseases

Objective To discuss the history and research progress of MR diffusion tensor imaging(DTI) in the diagnosis of spinal diseases. Methods To analyze and summarize the related literatures about the history and research progress of MR-DTI in the diagnosis of spinal diseases in the database of PubMed, Springer Link and CNKI with the key words of DTI, spinal, spine, etc. Results MR-DTI can reflect not only the early changes of local biological environment, but also the function of water exchange between the tissue components in early spinal cord lesions, it can also track nerve fibers and reflect the integrity of spinal cord. DTI has been gradually applied in the early diagnosis of cervical spondylotic myelopathy, the spinal cord injury period evaluation, the diagnosis of lumber and sacral nerve roots diseases, degeneration of lumber discs, etc. There is a gap between DTI technique and its clinical application in spinal cord lesions due to small volume of spinal cord, long scan time, motion artifacts, etc. With the development of medical imaging technologies, such as parallel imaging and single shot fast spin echo, these problems are being gradually solved. Conclusions DTI has played a significant role in the field of spinal diseases. With the application of more advanced techniques, we can work out solutions for the challenges and problems. DTI will become an unparalleled method in the early diagnosis of spinal diseases.