Department of Radiology, Stanford University School of Medicine, Stanford, California; and.
Department of Orthopaedics, Stanford University School of Medicine, Stanford, California.
J Nucl Med. 2018 Jun;59(6):967-972. doi: 10.2967/jnumed.117.198259. Epub 2017 Nov 2.
Chronic sciatica is a major cause of disability worldwide, but accurate diagnosis of the causative pathology remains challenging. In this report, the feasibility of an F-FDG PET/MRI approach for improved diagnosis of chronic sciatica is presented. F-FDG PET/MRI was performed on 9 chronic sciatica patients and 5 healthy volunteers (healthy controls). Region-of-interest analysis using SUV was performed, and F-FDG uptake in lesions was compared with that in the corresponding areas in healthy controls. Significantly increased F-FDG uptake was observed in detected lesions in all patients and was correlated with pain symptoms. F-FDG-avid lesions not only were found in impinged spinal nerves but also were associated with nonspinal causes of pain, such as facet joint degeneration, pars defect, or presumed scar neuroma. The feasibility of F-FDG PET/MRI for diagnosing pain generators in chronic sciatica was demonstrated, revealing various possible etiologies.
慢性坐骨神经痛是全球范围内导致残疾的主要原因,但准确诊断致病病理学仍然具有挑战性。在本报告中,提出了 F-FDG PET/MRI 方法在改善慢性坐骨神经痛诊断中的可行性。对 9 例慢性坐骨神经痛患者和 5 名健康志愿者(健康对照组)进行了 F-FDG PET/MRI 检查。使用 SUV 进行了感兴趣区分析,并比较了病变与健康对照组相应区域的 F-FDG 摄取。所有患者均在检测到的病变中观察到 F-FDG 摄取显著增加,与疼痛症状相关。F-FDG 摄取阳性的病变不仅存在受压的脊神经,还与非脊神经疼痛原因有关,如小关节退变、 pars 缺损或假定的瘢痕神经瘤。F-FDG PET/MRI 诊断慢性坐骨神经痛疼痛发生器的可行性得到了证实,揭示了各种可能的病因。