iMSDE MR神经成像在腰骶丛神经及其病变中的应用

摘要

目的 探讨iMSDE MR神经成像( iMSDE-MRN)在腰骶丛神经的成像特点及其临床应用价值,并与MR扩散加权背景抑制神经成像( DWIBS-MRN)对比分析. 方法 收集20例健康志愿者及30例腰骶丛神经病变的病例,分别行常规MR检查、iMSDE-MRN及DWIBS-MRN神经成像序列检查,对L5 及S1、S2、S3、S4 的显示情况进行评分对比,观察分析30例腰骶丛神经病变两种神经序列上神经和病变的显示情况,显示结果 与手术病理对照. 结果 iMSDE-MRN和DWIBS-MRN对L5、S1、S2、S3 的显示率达100%;iMSDE-MRN对S4 的显示效果明显尤于DWIBS-MRN,其差异有统计学意义( P <0.05). 对30例腰骶丛神经病变iMSDE-MRN均能清晰地显示腰骶丛神经的结构、走行及信号特征,特别是可以显示细小的神经结构,能够清楚显示病变对神经的包绕、推压等特征. iMSDE-MRN较DWIBS-MRN能更清楚的显示相关神经的细微结构及病变的信号特点. 结论 iMSDE-MRN可以清楚显示腰骶丛神经及病变的信号特点,特别是对细小的神经结构的显示优于DWIBS-MRN,为腰骶丛神经及其病变的显示提供了一种新的可行性方法 .%Objective To investigate the imaging characteristics and clinical value of iMSDE-MRN in lumbosacral plexus nerve, and to compare with DWIBS-MRN.Methods 20 healthy volunteers and 30 patients with lesions of lumbosacral plexus nerve underwent routine MR examination , iMSDE-MRN and DWIBS-MRN neurography sequence .The displaying situation of L 5 and S1 , S2 , S3 , S4 was analyzed with four-point grading scale .The images of 30 cases of lumbosacral plexus nerve lesions in two MRN sequences were observed and compared with surgical pathology .Results The display rates of L 5 S1 S2 S3 on iMSDE-MRN and DWIBS-MRN were 100%.The showing of S 4 on iMSDE-MRN was better than DWIBS-MRN, and the difference of two MRN sequences was statistical significance ( P <0.05).In 30 cases of lumbosacral plexus nerve lesions , iMSDE-MRN clearly showed structure and signal characteristics of the lumbosacral plexus , especially the tiny nerve structure , and the relationship between the lesions and nerves also showed clearly .Compared with DWIBS-MRN, iMSDE-MRN was better in showing tiny neural structure , singal characteristic of lesion , and relationship between lesions and the nerves .Conclusion iMSDE-MRN could clearly show the lumbosacral plexus , and is significantly better than DWIBS-MRN in showing small neural structures and relationship between nerve and lesions .It provides a new feasible method in diagnosis of disease of lumbosacral plexus .