3.0T磁共振扩张量成像对腰椎间盘突出致神经根受压的诊断价值及其与Oswestry功能障碍指数及视觉模拟评分的相关性

目的:研究3.0T磁共振扩张量成像(DTI)对腰椎间盘突出致神经根受压的诊断价值及其与Oswestry功能障碍指数(ODI)及视觉模拟评分(VAS)的相关性。方法:纳入我院从2017年1月~2019年1月收治的腰椎间盘突出致神经根受压患者50例进行研究,记作研究组。另取同期我院收治的单纯腰椎间盘突出患者50例作为对照组。两组受试者均接受DTI扫描以及ODI、VAS评分。比较两组神经根不同层面的各向异性分数(FA)值、弥散系数(ADC)值、ODI、VAS评分,并作相关性分析。同时,以手术病理诊断为金标准,分析DTI诊断腰椎间盘突出致神经根受压的敏感性、特异性、准确度。结果:研究组患者神经根近层、中层、远层的FA值均显著低于对照组,而ADC值均显著高于对照组(均P<0.05)。以手术病理诊断为金标准,DTI诊断腰椎间盘突出致神经根受压的敏感性为94.00%、特异性为96.00%、准确度为95.00%。研究组ODI、VAS评分分别为(43.22±7.25)分、(6.68±1.92)分,相较于对照组的(28.56±6.22)分、(4.02±1.34)分显著更高(均P<0.05)。经Pearson相关性分析可得:腰椎间盘突出致神经根受压患者的FA值与ODI、VAS评分均呈负相关关系(均P<0.05),而ADC值与ODI、VAS评分无相关性(均P>0.05)。结论:DTI对腰椎间盘突出致神经根受压的诊断价值较高,且FA值与ODI、VAS均存在明显相关性。临床工作中可能将DTI的FA值作为量化神经根结构改变的重要参数,值得临床重点关注。

The Diagnostic Value of 3.0T Magnetic Resonance Dilatation for Nerve Root Compression Caused by Lumbar Disc Herniation and Its Correlation with Oswestry Dysfunction Index and Visual Analogue Score

ABSTRACT Objective: To study the diagnostic value of 3.0T magnetic resonance dilatation (DTI) in the diagnosis of nerve root compression caused by lumbar disc herniation and its correlation with Oswestry dysfunction index (ODI) and visual analogue score (VAS). Methods: 50 patients with nerve root compression caused by lumbar disc herniation who were admitted to our hospital from January 2017 to January 2019 were included in the study group, which was recorded as the study group. In addition, 50 patients with simple lumbar disc herniation who were admitted to our hospital during the same period were taken as the control group. Subjects in both groups received DTI scanning and ODI and VAS scores. Fractional anisotropy (FA) values, dispersion coefficient (ADC) values, ODI and VAS scores at different levels of nerve roots in the two groups were compared, and the correlations were analyzed. At the same time, the sensitivity, specificity and accuracy of DTI in diagnosing nerve root compression caused by lumbar disc herniation were analyzed by using surgical and pathological diagnosis as the gold standard. Results: The FA values of the proximal, middle and distal nerve roots in the study group were significantly lower than those in the control group, while the ADC values were significantly higher than those in the control group (all P<0.05). Surgical and pathological diagnosis as the gold standard, the sensitivity of DTI in diagnosing nerve root compression caused by lumbar disc herniation was 94.00%, The specificity was 96.00% and the accuracy was 95.00%. The ODI and VAS scores of the study group were (43.22±7.25) score and (6.68±1.92) score, respectively, which were significantly higher than those of the control group (28.56±6.22) score and (4.02±1.34) score (all P<0.05). According to pearson correlation analysis, FA values of patients with lumbar disc herniation and nerve root compression were negatively correlated with ODI and VAS scores (all P<0.05), while ADC values were not correlated with ODI and VAS scores (all P>0.05). Conclusion: DTI has high diagnostic value for nerve root compression caused by lumbar disc herniation, and FA value is significantly correlated with ODI and VAS. In clinical work, FA value of DTI may be taken as an important parameter to quantify the changes of nerve root structure, which is worthy of clinical attention.