Feasibility of diffusion tensor imaging quantitative analysis in evaluation of nerve repair after minimally invasive surgery for lumbar disc herniation

Q4 Medicine Zhonghua fang she xue za zhi Chinese journal of radiology Pub Date : 2020-04-10 DOI:10.3760/CMA.J.CN112149-20190421-00026

Zhipeng Liu, Ying-cai Sun, Haofei Cui, J. Cui, Wei Zhang

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引用次数: 1

Abstract

前瞻性纳入2017年12月至2018年9月河北医科大学第三医院经临床及MRI确诊，并接受经皮椎间孔镜下髓核摘除术（PTED）治疗的19例腰椎间盘单侧侧后方突出患者，于术前1 d，术后3、30、90 d行腰5(L5）、骶1(S1）神经根扩散张量成像（DTI）。由2名放射科医师于L5、S1患侧神经近、中、远节段及同节段健侧相应部位以"播点"法勾画感兴趣区（ROI ），测量DTI参数各向异性分数（FA）和表观扩散系数（ADC）值，计算每侧神经3个ROI的平均值。采用配对t检验比较患侧与健侧神经DTI参数的差异，手术前后DTI参数的比较采用单因素方差分析或Kruskal-Wallis H检验。结果显示：（1）术前1 d L5神经患侧和健侧FA值分别为0.35±0.03、0.45±0.01, S1患侧和健侧分别为0.36±0.02、0.46±0.02，L5、S1患侧神经根FA值低于健侧（t=-10.188、-37.683，P均 0.05）。表明DTI可用于定量评估腰骶神经PTED术后修复状况。

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弥散张量成像定量分析评价微创腰椎间盘突出症术后神经修复的可行性

Prospective inclusion of 19 patients with unilateral posterior lumbar disc herniation who were diagnosed clinically and MRI at the Third Hospital of Hebei Medical University from December 2017 to September 2018 and underwent percutaneous transforaminal nucleus pulposectomy (PTED) treatment. Diffusion tensor imaging (DTI) of the L5 and S1 nerve roots was performed 1 day before surgery and 3, 30, and 90 days after surgery. Two radiologists delineated the region of interest (ROI) using the "seeding point" method at the proximal, middle, and distal segments of the affected nerves in L5 and S1, as well as the corresponding areas on the healthy side of the same segment. The anisotropy score (FA) and apparent diffusion coefficient (ADC) values of the DTI parameters were measured, and the average of three ROIs on each side of the nerves was calculated. Paired t-tests were used to compare the differences in DTI parameters between the affected and healthy sides of the nerve. The comparison of DTI parameters before and after surgery was performed using one-way ANOVA or Kruskal Wallis H-test. The results showed that: (1) On the 1st day before surgery, the FA values of the affected and healthy sides of the L5 nerve were 0.35 ± 0.03 and 0.45 ± 0.01, respectively. The FA values of the affected and healthy sides of the S1 nerve were 0.36 ± 0.02 and 0.46 ± 0.02, respectively. The FA values of the nerve roots on the L5 and S1 affected sides were lower than those on the healthy side (t=-10.188 and -37.683, both P=0.05). This indicates that DTI can be used to quantitatively evaluate the postoperative repair status of lumbar sacral nerve PTED.

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