Wang Lang, Shen Jiang, Das Sushant, Yang Hanfeng
Department of Radiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
North Sichuan Medical College, Nanchong, China.
Korean J Pain. 2020 Jul 1;33(3):275-283. doi: 10.3344/kjp.2020.33.3.275.
Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated.
The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading values for headache severity was calculated using a receiver operating characteristics curve. The correlation was analyzed with Pearson's coefficient.
The FA values of the symptomatic side of GON and cervical DRG (C2 and C3) were significantly lower than that of the asymptomatic side (all the < 0.001), while the ADC values were significantly higher ( = 0.003, < 0.001, and = 0.003, respectively). The FA value of 0.205 in C2 DRG was considered the grading parameter for headache severity with sensitivity of 0.743 and specificity of 0.999 ( < 0.001). A negative correlation and a positive correlation between the FA and ADC value of the GON and headache index (HI; r = -0.420, = 0.037 and r = 0.531, = 0.006, respectively) was found.
DTI parameters in the symptomatic side of the C2 and C3 DRG and GON were significantly changed. The FA value of the C2 DRG can grade headache severity. DTI parameters of the GON significantly correlated with HI.
先前的研究显示了枕大神经（GON）的神经成像和纤维束成像。本研究的目的是确定单侧颈源性头痛患者双侧GON和背根神经节（DRG）的扩散张量成像（DTI）参数，以及DTI对严重头痛的分级价值。评估DTI参数与临床特征之间的相关性。
测量双侧GON和颈DRG（C2和C3）的分数各向异性（FA）和表观扩散系数（ADC）值。使用受试者工作特征曲线计算头痛严重程度的分级值。用Pearson系数分析相关性。
GON和颈DRG（C2和C3）症状侧的FA值显著低于无症状侧（均P<0.001），而ADC值显著更高（分别为P = 0.003、P<0.001和P = 0.003）。C2 DRG中FA值为0.205被认为是头痛严重程度的分级参数，敏感性为0.743，特异性为0.999（P<0.001）。发现GON的FA和ADC值与头痛指数（HI）之间分别存在负相关和正相关（r = -0.420，P = 0.037和r = 0.531，P = 0.006）。
C2和C3 DRG及GON症状侧的DTI参数有显著变化。C2 DRG的FA值可对头痛严重程度进行分级。GON的DTI参数与HI显著相关。
