Perri Marco, Grattacaso Giuseppe, Di Tunno Valeria, Marsecano Claudia, Di Cesare Ernesto, Splendiani Alessandra, Gallucci Massimo
Biotechnological and Applied Clinical Sciences Department, University of L'Aquila, Italy.
Biotechnological and Applied Clinical Sciences Department, University of L'Aquila, Italy
Neuroradiol J. 2015 Apr;28(2):198-204. doi: 10.1177/1971400915576658. Epub 2015 Apr 13.
Evaluate the discal morpho-structural changes as a predictive sign in the clinical outcome after ozone therapy in lumbar disc herniation using the T2-shine through effect in diffusion-weighted imaging (DWI).
One hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; age range, 23-62 years) were included, previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences, and were randomly assigned to two groups. Seventy-seven patients (control group) underwent conservative treatment with intraforaminal injection of steroid and anaesthetic. The remaining 77 patients (study group) underwent the same treatment with the addition of oxygen-ozone (O2-O3). During the following six months, a MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ² test, Student's t test and analysis of covariance were used for comparison of variables.
In the study group, 58 of 77 patients had a successful outcome (responders). In the responders group, DWI T2-shine through effect was present during MRI follow-up and in particular in 53 of 77 patients in six months of follow-up (p < 0.05). Moreover, in the same group a statistically significant disc shrinkage was shown by IDVA in sixth months of follow-up (p < 0.05).
T2-shine through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.
利用扩散加权成像（DWI）中的T2透过效应，评估腰椎间盘突出症臭氧治疗后椎间盘形态结构变化作为临床预后的预测指标。
纳入154例腰腿痛患者（男89例，女65例；年龄范围23 - 62岁），之前进行过FSE - T2、T2脂肪抑制、SE - T1和DWI序列的磁共振成像（MR）检查，并随机分为两组。77例患者（对照组）接受椎间孔内注射类固醇和麻醉剂的保守治疗。其余77例患者（研究组）在相同治疗基础上加用氧 - 臭氧（O2 - O3）。在接下来的六个月中，采用相同序列进行MRI随访。进行椎间盘容积分析（IDVA）、DWI信号评分及治疗后临床预后评估以评估疝的减轻情况。采用χ²检验、学生t检验和协方差分析对变量进行比较。
研究组77例患者中58例预后良好（有反应者）。在有反应者组中，MRI随访期间出现DWI T2透过效应，尤其是在随访六个月时77例患者中的53例（p < 0.05）。此外，在同一组中，随访六个月时IDVA显示椎间盘有统计学意义的缩小（p < 0.05）。
DWI中的T2透过效应在椎间盘形态缩小之前出现，而且可被视为对氧 - 臭氧治疗反应的预测指标。
