腰椎间盘突出症患者受压神经根DTI与临床表现的相关性

摘要

Objective To explore changes of parameters of compressed nerve roots on diffusion tensor imaging (DTI) and relationship between the parameters and symptoms assessed with Oswestry disability index (ODI) and visual analogue score (VAS) in patients with lumbar disc herniation.Methods Twenty-five patients confirmed by surgery for single compressed nerve root with lumbar disc herniation who underwent DTI scanning before operation were enrolled.All patients were scored using ODI and VAS,and the areas of characteristic leg pain were compared with compressed nerve root for ODI and VAS.Results FA values of the compressed and normal nerve roots of these patients were 0.26 ±-0.05 and 0.36-±-0.05,while ADC values were (1.69 ±-0.32) × 10-3 mm2/s and (1.56 ± 0.21) × 10-3 mm2/s,respectively.Negative correlation was found between FA values of the compressed nerve roots and ODI (r=-0.88,P＜0.01) as well as VAS (r=-0.66,P＜0.01),but no correlation between ADC values and ODI (r=0.30,P =0.15) nor VAS (r=0.36,P =0.08) was found.Conclusion FA values derived from DTI maybe vital parameters of quantifying changes of structure of nerve root.Injury of nerve root structure in patients with lumbar disc herniation could be crucial for clinical symptoms.%目的 探讨腰椎间盘突出症患者受压神经根DTI相关参数的变化,及其与基于临床症状的Oswestry功能障碍指数(ODD、视觉模拟评分(VAS)的相关性.方法 25例经临床和手术证实为单侧神经根受压的腰椎间盘突出症患者纳入本研究,全部患者术前均接受DTI扫描和ODI与VAS评分,ODI、VAS用于评价患者受压神经根对应的特征性下肢疼痛区域.结果 腰椎间盘突出症患者患侧与健侧神经根FA值分别为0.26±0.05、0.36±0.05,ADC值分别为(1.69±0.32)×10-3mm2/s、(1.56±0.21)×10-3mm2/s;患侧 FA值与ODI(r=-0.88,P＜0.01)及VAS评分(r=-0.66,P＜0.01)呈负相关,ADC值与ODI(r=0.30,P=0.15)及VAS评分(r=0.36,P=0.08)无相关关系.结论 DTI的FA值可能是量化神经根结构改变的重要参数,腰椎间盘突出症患者神经根结构的损伤可能是产生临床症状的重要原因.