利用术前磁共振成像和调整最佳的穿刺方法来提高胸椎背根神经节的射频消融分数。
Utilizing pre-operative MR imaging and adapting optimal needle puncture approach to improve radiofrequency ablation fraction of thoracic dorsal root ganglia.
机构信息
The First Affiliated Hospital, Jinan University, Guangzhou, 510630, People's Republic of China.
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Nanchong, 637000, Sichuan, People's Republic of China.
出版信息
Sci Rep. 2021 Sep 20;11(1):18589. doi: 10.1038/s41598-021-98050-4.
This experimental study evaluates the location of thoracic dorsal root ganglions (DRGs) through magnetic resonance imaging (MRI) scans, and evaluates the radiofrequency ablation (RFA) fraction of different puncture approaches on distinct DRG locations. Eight normal adult corpse specimens were used as thoracic spine specimens. An MRI examination was performed on each specimen using the following MRI sequences: STIR T2WI, fs-FRFSE T2WI, and 3D FIESTA-c. Then thoracic spine specimens (n = 14) were divided into three groups for RFA: Group A, using a transforaminal approach irrespective of DRG location; Group B, using a transforaminal, trans-lateral-zygapophysial or translaminar approach according to the DRG location; and Group C using a combination of puncture approaches. The quality of visualization of thoracic DRGs on STIR T2WI, fs-FRFSE T2WI, and 3D FIESTA-c scans were 53.5% (77/144), 88.2% (127/144), and 93.1% (134/144), respectively. In group A, the RFA fractions of the extraforaminal DRGs (N = 29), intraforaminal DRGs (N = 12) and intraspinal DRGs (N = 7) via a transforaminal approach were 72.6 ± 18.9%, 54.2 ± 24.8% and 32.9 ± 28.1% respectively. In group B, RFA of extraforaminal DRGs via a transforaminal approach (N = 43) or a trans-lateral zygapophysial approach (N = 45) led to ablation fractions of 71.9 ± 15.2% and 72.0 ± 17.9%, respectively; RFA of intraforaminal DRGs via a transforaminal approach (N = 14) or a translaminar approach (N = 16) led to ablation fractions of 57.1 ± 18.0% and 52.5 ± 20.6%, respectively; RFA of intraspinal DRGs via a transforaminal approach (N = 12) or a translaminar approach (N = 14) led to ablation fractions of 34.8 ± 24.6% and 71.8 ± 16.0%, respectively. In group C, the combined approach led to an ablation fraction for extraforaminal DRGs (N = 69) of 82.5 ± 14.1%, for intraforaminal DRGs (N = 39) of 81.5 ± 11.8%, and for intraspinal DRGs (N = 36) of 80.8 ± 13.3%. MRI can accurately assess DRG location before RFA. Adopting different and combined puncturing approaches tailored to different DRG locations can significantly increase the DRG RFA fraction.
本实验研究通过磁共振成像（MRI）扫描评估胸背部脊神经根节（DRG）的位置，并评估不同穿刺入路在不同 DRG 位置对射频消融（RFA）的影响。8 具正常成人尸体标本作为胸脊柱标本。对每个标本进行以下 MRI 序列检查：STIR T2WI、fs-FRFSE T2WI 和 3D FIESTA-c。然后将 14 个胸脊柱标本分为 3 组进行 RFA：A 组，无论 DRG 位置如何，均采用经椎间孔入路；B 组，根据 DRG 位置，采用经椎间孔、经外侧-关节突或经皮入路；C 组，采用联合穿刺入路。STIR T2WI、fs-FRFSE T2WI 和 3D FIESTA-c 扫描中胸 DRG 的可视化质量分别为 53.5%（77/144）、88.2%（127/144）和 93.1%（134/144）。在 A 组中，通过经椎间孔入路对椎间孔外 DRG（N=29）、椎间孔内 DRG（N=12）和椎管内 DRG（N=7）的 RFA 分数分别为 72.6±18.9%、54.2±24.8%和 32.9±28.1%。在 B 组中，经椎间孔入路（N=43）或经外侧关节突入路（N=45）对椎间孔外 DRG 的 RFA 导致消融分数分别为 71.9±15.2%和 72.0±17.9%；经椎间孔入路（N=14）或经皮入路（N=16）对椎间孔内 DRG 的 RFA 导致消融分数分别为 57.1±18.0%和 52.5±20.6%；经椎间孔入路（N=12）或经皮入路（N=14）对椎管内 DRG 的 RFA 导致消融分数分别为 34.8±24.6%和 71.8±16.0%。在 C 组中，联合入路导致椎间孔外 DRG（N=69）的 RFA 分数为 82.5±14.1%，椎间孔内 DRG（N=39）的 RFA 分数为 81.5±11.8%，椎管内 DRG（N=36）的 RFA 分数为 80.8±13.3%。MRI 可在 RFA 前准确评估 DRG 位置。采用针对不同 DRG 位置的不同和联合穿刺入路可以显著提高 DRG 的 RFA 分数。
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