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目的:比较周围神经背景信号抑制弥散加权成像(diffusion-weighted neuroimag ing with background signal suppression,DWIBS)、选择性激励技术(principle of selective excitation technique,PROSET)及三维短时反转恢复(3D Short Term Inversion Recovery,3D STIR)序列在腰骶部脊神经成像中的不同表现,探讨其对腰骶部病变的临床应用价值。方法:对29名正常志愿者及42例腰骶丛病变损伤患者行磁共振腰骶丛神经成像,包括DWIBS序列,PROSET及3D STIR序列。对DWIBS及3D STIR原始图像行最大信号强度投影(MIP)后处理重建,对志愿者组及病变组所得图像质量分级并分别进行统计分析,评价三种高场强磁共振腰骶丛神经成像序列在正常组及病变组的显示效果。结果:在正常志愿者组中,三种高场强磁共振腰骶丛神经成像序列均可显示脊神经根、神经节等解剖细节,对于腰4、5脊神经的显示,三者的图像分级差异不具有统计学意义。在腰2、3脊神经成像中,三者图像质量分级的差异具有统计学意义(P<0.05)。在病例组中,经秩和检验三组组间显示效果不完全相同,P<0.05,差异有统计学意义。进行两两比较,DWIBS与3D SITR序列,其差异具有统计学意义(P<0.01)。PROSET与3D STIR序列,差异具有统计学意义(P<0.01)。而DWIBS与PROSET图像质量分级差异无明显统计学差异。结论:DWIBS、PROSET、3DSTIR序列作为常规序列的补充,均可完整的显示腰骶神经的解剖细节,而DWIBS及PROSET序列对背景组织的抑制更加充分,更利于观察神经的走行变化、判断神经受损部位及范围。DWIBS序列MIP后处理图像实现了对腰骶神经的多方位多角度旋转观察,为术前制定手术方案提供可靠的影像学依据,弥补了常规磁共振序列的不足。
Objective: To compare diffusion-weighted neuroimag ing with background signal suppression (DWIBS), principle of selective excitation technique (PROSET) and 3D Short Term Inversion Recovery, 3D STIR) sequences in lumbosacral spinal nerve imaging, and to explore its clinical value in lumbosacral lesions. Methods: Magnetic resonance imaging of lumbosacral plexus was performed in 29 normal volunteers and 42 patients with lesions of lumbosacral plexus, including DWIBS, PROSET and 3D STIR sequences. The maximum signal intensity projection (MIP) post-processing reconstruction of DWIBS and 3D STIR original images was performed. The image quality of the volunteer group and the lesion group was graded and statistically analyzed respectively. Three high-field MRI lumbosacral plexus neuroimaging sequences In the normal group and lesion group display effect. Results: In the normal volunteer group, three kinds of MRI images of lumbosacral plexus in high field MRI showed anatomical details such as spinal nerve root and ganglion. For the display of the lumbar 4 and 5 spinal nerves, has statistical significane. In the lumbar 2,3 spinal nerve imaging, the differences of the three image quality grading were statistically significant (P <0.05). In the case group, the result of rank sum test did not show the same effect among the three groups, P <0.05, the difference was statistically significant. For any pairwise comparisons, the difference between DWIBS and 3D SITR sequences was statistically significant (P <0.01). PROSET and 3D STIR sequences, the difference was statistically significant (P <0.01). However, DWIBS and PROSET had no significant difference in image quality grading. CONCLUSIONS: DWIBS, PROSET and 3DSTIR sequences can supplement the conventional sequences to completely display the anatomical details of lumbosacral nerves. However, DWIBS and PROSET sequences can inhibit the background tissue more adequately, which is more conducive to observing the changes of nerves and determining the nerve receptors Loss of parts and range. DWIBS sequence MIP post-processing images to achieve the lumbosacral nerve multi-directional multi-angle rotation of observation, preoperative surgical planning to provide a reliable imaging basis to make up for the lack of conventional magnetic resonance sequences.