MRI STIR序列对非神经根源性腰痛患者的诊断价值

The diagnosis value of MRI STIR sequence in nonradicular back pain

中文关键词:  腰痛  磁共振成像  STIR序列  非神经根源性

英文关键词:Back pain  Magnetic resonance imaging  short T1 inversion-recovery sequence  Nonradicular

中文摘要:

  【摘要】 目的：观察MRI检查中短T1反转回复（short T1 inversion-recovery，STIR）成像技术对于非神经根源性腰痛患者腰椎退变性病变的显示能力，评价其临床应用价值。方法：2010年9月～2011年6月对在我院就诊的有腰痛症状但无神经根放射痛症状的患者进行腰椎MRI扫描，共纳入130例患者，其中男89例，女41例，年龄17~81岁，平均48.3±16.0岁。病史均超过1年。MRI扫描序列包括：矢状面TSE-T1WI、TSE-T2WI、STIR序列，横断面TSE-T2WI序列。对STIR图像及TSE-T2WI图像上腰椎退变性病变进行观察，观察内容包括：L1～S1椎间盘退变情况、椎间盘突出/膨出的节段及程度、腰椎小关节骨质增生情况、棘间韧带水肿情况和腰背部皮下软组织水肿情况。分别对STIR序列与TSE-T2WI序列发现腰椎间盘退变、椎间盘突出/膨出、椎小关节病变、腰部软组织病变的能力进行比较。结果：130例非神经根源性腰痛患者中，STIR序列对于腰椎间盘退变、棘间韧带水肿及腰背部皮下软组织水肿的检出数分别为482个、118节和25例，TSE-T2WI序列检出311个、42节和8例，两序列检出率有显著性差异（P<0.05）；STIR与TSE-T2WI序列对于腰椎间盘突出/膨出和椎小关节骨质增生的检出数均为182个和71个，无差异。两序列均发现5例腰椎滑脱，19例腰椎管狭窄。结论：MRI STIR序列对非神经根源性腰痛患者腰椎间盘退变、棘间韧带水肿及腰背部皮下软组织水肿显示能力优于MRI T2WI。

英文摘要:

  【Abstract】 Objectives: To assess the clinical value of short T1 inversion-recovery(STIR) sequence of MRI in detecting degenerative changes of nonradicular back pain, comparing with TSE-T2WI sequence. Methods: From September 2010 to June 2011, all patients with nonradicular back pain in our hospital were performed MRI. Those patients with the history longer than 1 year were included in this study. A total of 130 patients was recruited, including 89 males and 41 females, with a mean age of 48.3±16.0(17~81 years). MRI scan included sagittal TSE-T1WI, TSE-T2WI, STIR sequence, and axial TSE-T2WI. Data were retrieved and analyzed to compare the ability of STIR and TSE-T2WI sequence in detecting degenerative pathology of back pain. Information of intervertebral lumbar disc degeneration and extrusion was observed and recorded, the facet joint hyperostosis, interspinous ligament edema and subcutaneously soft tissue edema were noted. Chi-square test was performed to compare the ability of STIR and TSE-T2WI in detecting degenerative changes of nonradicular back pain. Results: Of 130 patients with nonradicular back pain, intervertebral disc degeneration, interspinous ligament edema and subcutaneously soft tissue edema were found more at STRI sequence(482, 118 and 25 cases, respectively) than at TSE-T2WI sequence (311, 42 and 8 cases, espectively)(P<0.05). 182 intervertebral disc extrusion and 71 facet joint hyperostosis were detected by both STIR sequence and TSE-T2WI sequence(P>0.05). 5 lumbar spondylolithesis and 19 spinal stenosis were found by both sequences. Conclusions: MRI STIR is of great value in detecting degenerative changes of nonradicular back pain, especially intervertebral disc degeneration, interspinous ligament edema and subcutaneously soft tissue edema.