Eguchi Y, Oikawa Y, Suzuki M, Orita S, Yamauchi K, Suzuki M, Aoki Y, Watanabe A, Takahashi K, Ohtori S
Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, 284-0003, Japan.
Chiba Children's Hospital, 579-1 Heta-Chou, Midori-ku, Chiba, 266-0007, Japan.
Bone Joint J. 2016 Mar;98-B(3):387-94. doi: 10.1302/0301-620X.98B3.36036.
The aim of this study was to evaluate the time course of changes in parameters of diffusion tensor imaging (DTI) such as fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in patients with symptomatic lumbar disc herniation. We also investigated the correlation between the severity of neurological symptoms and these parameters.
A total of 13 patients with unilateral radiculopathy due to herniation of a lumbar disc were investigated with DTI on a 1.5T MR scanner and underwent micro discectomy. There were nine men and four women, with a median age of 55.5 years (19 to 79). The changes in the mean FA and ADC values and the correlation between these changes and the severity of the neurological symptoms were investigated before and at six months after surgery.
The mean FA values were significantly lower (p = 0.0005) and mean ADC values were significantly higher (p = 0.0115) in compressed nerves than in intact nerves. Although the FA values increased significantly at six months after surgical treatment (p = 0.020), the ADC values decreased but not significantly (p = 0.498). There were strong correlations between the DTI parameters such as the FA value and the severity of the neurological symptoms as assessed using the Japanese Orthopaedic Association (JOA) score and the Roland-Morris Disability Questionnaire (RDQ).
This preliminary study suggests that it may be possible to use DTI to diagnose, quantitatively evaluate and follow-up patients with lumbar nerve entrapment.
DTI is a potential tool for functional diagnosis of lumbar nerve damage.
本研究旨在评估有症状的腰椎间盘突出症患者扩散张量成像（DTI）参数，如分数各向异性（FA）和表观扩散系数（ADC）随时间的变化过程。我们还研究了神经症状严重程度与这些参数之间的相关性。
共有13例因腰椎间盘突出导致单侧神经根病的患者在1.5T磁共振成像扫描仪上接受DTI检查，并接受了显微椎间盘切除术。其中男性9例，女性4例，中位年龄55.5岁（19至79岁）。研究了手术前和术后6个月平均FA值和ADC值的变化，以及这些变化与神经症状严重程度之间的相关性。
受压神经的平均FA值显著降低（p = 0.0005），平均ADC值显著升高（p = 0.0115），高于未受压神经。虽然手术治疗6个月后FA值显著升高（p = 0.020），但ADC值下降但不显著（p = 0.498）。使用日本骨科协会（JOA）评分和罗兰 - 莫里斯残疾问卷（RDQ）评估，FA值等DTI参数与神经症状严重程度之间存在强相关性。
这项初步研究表明，有可能使用DTI对腰椎神经受压患者进行诊断、定量评估和随访。
DTI是腰椎神经损伤功能诊断的潜在工具。
