Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 10053, China.
National Clinical Research Center for Geriatric Diseases, Beijing, 10053, China.
Eur Spine J. 2021 Apr;30(4):855-864. doi: 10.1007/s00586-020-06600-7. Epub 2020 Sep 16.
To investigate the diagnostic value of contrast-enhanced three-dimensional (3D) T2-weighted turbo spin-echo SPACE (T2-SPACE) sequence in LNRC.
A total of 90 surgically confirmed LNRC patients with 165 explored nerve roots were enrolled in this study. Diagnostic values were quantified using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. The consistency between 2D MRI and 3D T2-SPACE MRI was quantified using kappa test. The compression of specific branch in nerve root was evaluated on 2D MRI, 3D T2-SPACE MRI, and surgical findings. The pedicle height, vertebral body height (VH), proximal tilting angle of nerve root (PTA) were measured on MR images.
The sensitivity, specificity, PPV, NPV, and accuracy by 2D MRI were 78.3%, 72.7%, 94.9%, 34.0%, and 77.6%, respectively. For 3D T2-SPACE MRI imaging, the sensitivity, specificity, PPV, NPV, and accuracy were 91.6%, 86.4%, 97.8%, 61.3%, and 90.9%, respectively. 2D MRI and 3D T2-SPACE MRI for detection of intra-foramen and extra-foramen nerve compression showed poor homogeneity (Kappa = 0.333, Kappa = 0.276, respectively). Smaller VHs and larger PTAs could be indicators for the diagnosis of foraminal nerve root compression.
3D T2-SPACE MRI had a higher sensitivity, specificity, PPV, NPV, and accuracy than 2D MRI for detecting LNRC. The 3D T2-SPACE scan could be a good substitute to routine 2D MRI in LNRC diagnosis, especially for foraminal nerve root compression patients.
III.
探讨对比增强三维（3D）T2 加权涡轮自旋回波空间（T2-SPACE）序列在腰椎间盘侧隐窝狭窄症（LNRC）中的诊断价值。
本研究共纳入 90 例经手术证实的 LNRC 患者，共 165 条神经根。采用敏感度、特异度、阳性预测值（PPV）、阴性预测值（NPV）和准确率来量化诊断价值。采用 Kappa 检验量化 2D MRI 和 3D T2-SPACE MRI 之间的一致性。在 2D MRI、3D T2-SPACE MRI 和手术发现中评估神经根特定分支的受压情况。在 MR 图像上测量椎弓根高度、椎体高度（VH）、神经根近端倾斜角（PTA）。
2D MRI 的敏感度、特异度、PPV、NPV 和准确率分别为 78.3%、72.7%、94.9%、34.0%和 77.6%。对于 3D T2-SPACE MRI 成像，敏感度、特异度、PPV、NPV 和准确率分别为 91.6%、86.4%、97.8%、61.3%和 90.9%。2D MRI 和 3D T2-SPACE MRI 检测椎间孔内和椎间孔外神经根受压显示出较差的同质性（Kappa 值分别为 0.333 和 0.276）。较小的 VH 和较大的 PTA 可能是诊断椎间孔神经根受压的指标。
3D T2-SPACE MRI 检测 LNRC 的敏感度、特异度、PPV、NPV 和准确率均高于 2D MRI。3D T2-SPACE 扫描可以作为 LNRC 诊断的常规 2D MRI 的良好替代方法，特别是对于椎间孔神经根受压患者。
III 级。
