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MRI 曲面重建对成人退变性腰椎侧凸神经根定位中腰骶神经根的诊断价值。

Diagnostic value of curved planar reformation of MRI for lumbosacral nerve roots in the localization of nerve roots for adult lumbar degenerative scoliosis.

机构信息

Department of Spinal Surgery, The Second Hospital of Shandong University, Jinan, Shandong Province, China.

Department of Spinal, First Peoples' Hospital of Pingyuan County, Dezhou, Shandong Province, China.

出版信息

Eur Spine J. 2023 Mar;32(3):926-933. doi: 10.1007/s00586-023-07531-9. Epub 2023 Jan 17.

Abstract

PURPOSE

To compare the diagnostic value of curved planar reformation of MRI (MRI-CPR) and 2D MRI in determining the responsible nerve in patients with adult lumbar degenerative scoliosis (ALDS).

METHOD

A total of 45 patients diagnosed with ALDS were included in the study. All patients underwent MRI-CPR and 2D MRI and subsequently received surgery. These two diagnostic methods were compared with the results of surgical exploration to assess nerve root compression.

RESULTS

The sensitivity and accuracy of MRI-CPR are higher than 2D MRI (93.8% vs 80.0%; 92.8% vs 77.7%, respectively). And the specificity of MRI-CPR is higher than 2D MRI (87.5% vs 68.8%). Besides, the PPV and NPV of MRI-CPR are higher than 2D MRI (96.8% vs 91.2%; 7.8.% vs 45.8%). The area (AUC) under the receiver operating characteristic curve (ROC) for MRI-CPR and 2D MRI was 0.74 and 0.91, respectively. The judgement was made by two independent radiologists, while the consistency tests for 2D MRI and MRI-CPR with Kappa values were 90.6% and 82.2%, respectively.

CONCLUSIONS

The clinical diagnostic value of MRI-CPR was better than 2D MRI in the determination of the responsible nerve root. Moreover, MRI-CPR sequence images can clearly show the route of lumbosacral nerve roots and their relationship with adjacent tissues. Therefore, MRI-CPR can be an important complement to conventional 2D MRI in the diagnosis of responsible nerve roots in patients with ALDS.

摘要

目的

比较磁共振成像(MRI)曲面重建(MRI-CPR)与 2D MRI 在确定成人退变性腰椎侧凸(ALDS)患者责任神经中的诊断价值。

方法

共纳入 45 例诊断为 ALDS 的患者。所有患者均接受 MRI-CPR 和 2D MRI 检查,随后接受手术。比较两种诊断方法与手术探查结果,评估神经根受压情况。

结果

MRI-CPR 的敏感性和准确性均高于 2D MRI(93.8%比 80.0%;92.8%比 77.7%)。MRI-CPR 的特异性也高于 2D MRI(87.5%比 68.8%)。此外,MRI-CPR 的阳性预测值(PPV)和阴性预测值(NPV)均高于 2D MRI(96.8%比 91.2%;7.8.%比 45.8%)。MRI-CPR 和 2D MRI 的受试者工作特征曲线(ROC)下面积(AUC)分别为 0.74 和 0.91。该判断由两位独立的放射科医生做出,而 2D MRI 和 MRI-CPR 的一致性检验 Kappa 值分别为 90.6%和 82.2%。

结论

MRI-CPR 在确定责任神经根方面的临床诊断价值优于 2D MRI。此外,MRI-CPR 序列图像可清晰显示腰骶神经根的走行及其与邻近组织的关系。因此,MRI-CPR 可作为常规 2D MRI 在诊断 ALDS 患者责任神经根的重要补充。

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