CN107174248A - A kind of radiculoneuropathy based on Diffusion Tensor Imaging becomes quantitative evaluation method - Google Patents
A kind of radiculoneuropathy based on Diffusion Tensor Imaging becomes quantitative evaluation method Download PDFInfo
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- 238000002598 diffusion tensor imaging Methods 0.000 title claims abstract description 42
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- 239000000835 fiber Substances 0.000 claims abstract description 59
- 210000000273 spinal nerve root Anatomy 0.000 claims abstract description 29
- 238000003384 imaging method Methods 0.000 claims abstract description 19
- 230000003902 lesion Effects 0.000 claims abstract description 10
- 238000009792 diffusion process Methods 0.000 claims abstract description 6
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- 238000001514 detection method Methods 0.000 abstract description 3
- 238000011156 evaluation Methods 0.000 abstract description 2
- 230000003447 ipsilateral effect Effects 0.000 description 13
- 210000005036 nerve Anatomy 0.000 description 10
- 208000003618 Intervertebral Disc Displacement Diseases 0.000 description 4
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- 238000012360 testing method Methods 0.000 description 3
- 206010061246 Intervertebral disc degeneration Diseases 0.000 description 2
- 206010037779 Radiculopathy Diseases 0.000 description 2
- 208000018180 degenerative disc disease Diseases 0.000 description 2
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- 206010050296 Intervertebral disc protrusion Diseases 0.000 description 1
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- 208000020307 Spinal disease Diseases 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
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Abstract
Become quantitative evaluation method the present invention relates to a kind of radiculoneuropathy based on Diffusion Tensor Imaging, sagittal plain T2WI and axle position T2WI sequence scannings are carried out first, it was found that lesion spinal nerve root position, axle position DTI scannings are carried out to lesion plane, DTI uses 3.0 T MRI single-shot spin echo plane imaging sequences（single shot‑spin echo planar imaging sequence）, obtain diffusion tensor view data；It is then determined that the region of interest of spinal nerve root Diffusion Tensor Imaging, calculate the number of the fibre bundle in drawn region of interest and draw fiber spike figure, the Volume one softwares of the fibre bundle algorithm tracked based on certainty, spinal nerve root Structure Quantification is evaluated, good reliability of the present invention, it is reproducible, new evaluation criterion is provided for clinical detection.
Description
Technical field
The present invention relates to mr imaging technique field, more particularly to a kind of ridge god based on Diffusion Tensor Imaging
Become quantitative evaluation method through root disease.
Background technology
Spinal nerve root diffusion tensor imaging (diffusion tensorimaging, DTI）Carried for the reconstruction of neuromechanism
A kind of detection means of effective hurtless measure has been supplied, can be used in disorderly nerve fibre bundle under spinal nerve root degree of impairment, destruction, become
The measurement of shape.
Present spinal nerve DTI imaging methods still lack unified standard, and current spinal nerve root DTI imaging method multiselects
Region of interest is selected at lesion spinal nerve root, conventional region of interest is to observe by the naked eye spinal nerve location of root to select,
System of selection subjectivity is strong, repeatability is poor.The selection of thickness, dispersal direction and b values then lacks unified standard, and dispersal direction
More, imaging time is longer；B values are bigger, and signal noise ratio (snr) of image is poorer, and without prior art to spinal nerve root 26S Proteasome Structure and Function
Carry out quantitatively evaluating.
The spike imaging that DTI is imaged to nerve root fibers beam needs to realize by software.Algorithm on fiber tractography
Software has two kinds, and being to determine property of one kind is tracked, and another is probability tracking.Probability tracking can estimate fiber orientation not
Certainty, for solving the problems, such as that fiber crossovers have certain help in pixel, but this algorithm needs to gather more gradient direction
DTI images, can substantially increase sweep time, not only increase time cost, and patient also is difficult to be resistant to prolonged inspection,
And computationally intensive because data are more, data processing is cumbersome.Comparatively certainty tracking can use less gradient direction
Realize, save the time, and calculate very fast, easy, but for fibre bundle in the case of of crossing one another in pixel can not solve, but
There is no final conclusion at present, which kind of is more suitable for the imaging of spinal nerve root, and the research for being directed to this respect without prior art carried out report
Road.
The content of the invention
The technical problems to be solved by the invention overcome of the prior art not enough high, repeated there is provided a kind of accuracy
Good, imaging time is short and the ridge based on Diffusion Tensor Imaging of quantization modulation can be carried out to the structure function of nerve root
Radiculopathy quantitative evaluation method,
To solve the above problems, the technical solution used in the present invention is：
A kind of radiculoneuropathy based on Diffusion Tensor Imaging becomes quantitative evaluation method, and it comprises the following steps：
Step 1：Sagittal plain T2WI and axle position T2WI sequence scannings are carried out first, find lesion spinal nerve root position, it is flat to lesion
Face carries out axle position DTI scannings, and DTI uses 3.0 T MRI single-shot spin echo plane imaging sequences（single shot-
spin echo planar imaging sequence）, obtain diffusion tensor view data；
Step 2：The region of interest of spinal nerve root Diffusion Tensor Imaging is determined, the system of selection of region of interest is as follows：Sense
Region of interest (region of interest, ROI) selects left and right sides intervertebral bore region, is symmetric the ROI of both sides,
And size convergence is consistent, specific method is first to draw the vertical curve along centrum center position, then, is found by intervertebral foramen
The oblique line of center, both sides oblique line should be symmetrical, i.e., be in same angle with vertical curve.Then drawn on oblique line normal thereto
4, line segment, a length of 2 ± 0.1mm, central point is located on oblique line, and the spacing of every line segment is 3 ± 0.1mm, most inner side line segment and vertebra
The distance of pipe dural sac is also 3 ± 0.1mm, and oblique line is sequentially connected with dural sac intersection point and each line segment end points, as felt
Region of interest；
Step 3：Data processing, calculates the number of the fibre bundle in drawn region of interest and draws fiber spike figure, based on determination
Property tracking fibre bundle algorithm Volume one softwares；
Step 4：Spinal nerve root Structure Quantification is evaluated.
Preferably, in step 1, DTI uses TR/TE：2300/75.5 ms, thickness 5mm do not have an interlamellar spacing, 256 ×
256 matrixes, FOV38 × 38mm.
Preferably, in step 1, DTI uses b values for 0 and 600 s/mm2, 6 directions.
Preferably, in step 1, sagittal plain T2WI parameters：TR2500ms, TE108.9ms；Axle position T2WI parameters：
TR2440ms, TE120.8ms.
Preferably, in step 3, anisotropy（Fractional anisotropy, FA）Threshold value is 0.18.
Preferably, the method for quantitatively evaluating in step 4 is that fibre bundle form is divided into more than complete and imperfect, branch and divided
Branch is few, complete and branch is generally 2 points, and complete but branch is 1 point less, and many but imperfect branches are also 1 point, imperfect and branch is few
For 0 point, described branch is generally to be more than or equal to 5, and few described branch is less than 5.
It is using the beneficial effect produced by above-mentioned technical proposal：
The region of interest that the present invention passes through objective, accurate selection spinal nerve root diffusion tensor imaging, it is ensured that diffusion tensor imaging can
It is reproducible, the 26S Proteasome Structure and Function of spinal nerve root is intuitively measured by fiber tractography, and its 26S Proteasome Structure and Function is quantified
It is classified and becomes quantitative evaluation method there is provided a kind of feasible radiculoneuropathy, new evaluation criterion is provided for clinical detection.
Fiber tractography result is relevant with the selection and FA threshold value settings of region of interest.The application using intervertebral bore region as
The region of interest of fiber tractography imaging, is because intervertebral disc protrusion/protrusion causes root compression always to occur from this area
Domain, therefore the spinal nerve root situation in this region can be shown that whether occur in that radiculopathy.FA is to represent diffusion anisotropy
Numerical value, FA values are bigger, illustrate that the anisotropy signal of diffusion is stronger, as FA=0, show to wait direction to spread completely, when FA=1
When, show only to spread along a direction.But, the measurement of FA values can be by fibre bundle cross influence.The position intersected in fibre bundle,
FA values reduce, and program is possible to select the fibre bundle unrelated with anatomy to implement to follow the trail of or stop tracking.Carry out fiber with
, it is necessary to set a certain FA threshold values when track, that is, represent to stop carrying out fibre bundle tracking when FA values are less than the value.Therefore, this Shen
Please be 0.18 by exploring selection threshold value.Result of the test confirms that this threshold value is effective.
By experimental verification, by using DTI single-shot spin echo plane imaging sequences, setting b values are 600, are expanded
It is 6 to dissipate direction, and accurately delineates region of interest, sets FA threshold values as 0.18, and sets up Evaluating Quantitative System, can accurately be commented
Valency spinal nerve root function, scanning process was completed within 4 minutes, and the time is short, precision is high.
Brief description of the drawings
, below will be to specific in order to illustrate more clearly of the specific embodiment of the invention or technical scheme of the prior art
The accompanying drawing used required in embodiment or description of the prior art is briefly described.
Fig. 1 spinal nerve root fibers beam region of interest explication schematic diagrames；
Fig. 2 lumbar vertebrae sagittal plains T2WI schemes；
Fig. 3；The horizontal slice T2WI of waist 4/5 schemes；
Fig. 4；Spinal nerve root fibers spike figure region of interest on the right side of the interverbebral disc plane of waist 4/5；
Fig. 5；Spinal nerve root fibers spike figure on the right side of the interverbebral disc plane of waist 4/5；
Fig. 6；Spinal nerve root fibers spike figure region of interest on the left of the interverbebral disc plane of waist 4/5；
Fig. 7；Spinal nerve root fibers spike figure on the left of the interverbebral disc plane of waist 4/5.
In the accompanying drawings：Before 1 sympathetic ganglion, 2 grey branch, 3 sinus nervi vertebralises, 4 spinal nerves in branch, 5 back of the body branch, 6 side shoots, 7
Between branch, 8 medial branch, 9 vertical curves, 10 oblique lines, 11 line segments, 12 region of interest.
Embodiment
To make the object, technical solutions and advantages of the present invention clearer, invention is carried out with reference to specific embodiment
Clear, complete description.
Radiculoneuropathy of the present invention based on Diffusion Tensor Imaging becomes quantitative evaluation method, and concrete operations are as follows：
The first step：Sagittal plain T2WI and axle position T2WI sequence scannings are carried out first, find lesion spinal nerve root position, it is flat to lesion
Face carries out axle position DTI scannings, and DTI uses 3.0 T MRI single-shot spin echo plane imaging sequences（single shot-
spin echo planar imaging sequence）, obtain diffusion tensor view data, TR/TE：2300/75.5ms, layer
Thick 5mm does not have an interlamellar spacing, 256 × 256 matrixes, FOV38 × 38mm, and b values are 0 and 600s/mm2, 6 directions, sagittal plain T2WI
Parameter：TR2500ms, TE108.9ms；Axle position T2WI parameters：TR2440ms, TE120.8ms.
Step 2：The region of interest of spinal nerve root Diffusion Tensor Imaging is determined, the system of selection of region of interest is such as
Under：Region of interest (region of interest, ROI) selects left and right sides intervertebral bore region, makes the ROI of both sides in symmetrical
Distribution, and size convergence is consistent, specific method is first to draw the vertical curve along centrum center position, then, is found by vertebra
Between hole center oblique line, both sides oblique line should be symmetrical, i.e., with vertical curve in same angle.Then draw and hang down therewith on oblique line
4, straight line segment, a length of 2 ± 0.1mm, central point is located on oblique line, and the spacing of every line segment is 3 ± 0.1mm, most inner side line segment
Distance with canalis spinalis dural sac is also 3 ± 0.1mm, oblique line is sequentially connected with dural sac intersection point and each line segment end points, i.e.,
For region of interest；
Step 3：Data processing, calculates the number of the fibre bundle in drawn region of interest and draws fiber spike figure, utilize
Volume one softwares carry out the Three-dimensional Display of the missing figure of fibre bundle on computers（See accompanying drawing 1）, carrying out fibre bundle tracking
When, selection FA threshold values are 0.18, calculate the number of drawn interior fibre bundle interested and draw fiber tractography figure.
Step 4：Spinal nerve root Structure Quantification is evaluated, and fibre bundle form is divided into more than complete and imperfect, branch and branch
Few, complete and branch is generally 2 points, complete but branch is 1 point less, and it is also 1 point that branch is more but imperfect, and imperfect and branch is less
0 point, described branch is generally to be more than or equal to 5, described branch is few be less than 5, can be to god by this hierarchy system
Become situation through root disease effectively and reliably to be evaluated.
In order to verify the reliability of the inventive method, following clinical test has been carried out：
1. research object
Collect 18 patients in January, 2012-December.Age 20-72 Sui, average age 53.33 ± 13.25 years old.Wherein male 8
Example, women 10.Inclusive criteria：（1）Clinical symptoms are rear backache and/or lower limb pain, with or without lower limb function barrier
Hinder；（2）Intervertebral disc degeneration can be seen on MR images；（3）Disc herniation/bulging only results in unilateral root compression；（4）Nerve
Root, which is pressurized, refers to that nerve root is extruded and offset or unclear in flat and interverbebral disc boundary by disc tissue.（5）Without other
Spinal disease.Exclusion standard：（1）With other lumbar disc diseases in addition to backbone regression；（2）There is wound medical history；（3）Intervertebral
Disk protrusion/bulging causes bilateral nerve root to be pressurized.All subjects sign informed consent form.
2. instrument and scanning
This research uses Signa Excite HD 3.0T (GE companies of the U.S.) high field intensity MR scanners, uses spine coil.By
Examination person takes tight plug cotton balls in dorsal position, ears, keeps normal respiration, and midline of body is located at hub of a spool, cephalocaudal axis and main magnetic
Head's axle is parallel.Scanning sequence includes sagittal plain T1WI, sagittal plain and the axle position T2WI and axle position DTI of standard.DTI uses single
Excite spin echo plane imaging sequence（single shot-spin echo planar imaging sequence）, TR/
TE:2300/75.5 ms, thickness 5mm do not have an interlamellar spacing, 256 × 256 matrixes, FOV38 × 38mm, and b values are 0 and 600 s/
Mm2,6 directions.Sagittal plain T1WI parameters：TR 3294ms, TE 25.4ms.Sagittal plain T2WI parameters：TR 2500ms, TE
108.9ms.Axle position T2WI parameter TR 2440ms, TE 120.8ms.
3 measured values and method
According to T2WI image findings, to unilateral root compression situation caused by patient's degenerative lumbar and disc herniation/bulging
Diagnosed.Then, the Three-dimensional Display of fiber tractography figure is carried out on computers using volume one softwares.Region of interest
(region of interest, ROI) selects left and right sides intervertebral bore region, is as far as possible symmetric the ROI of both sides, and
Size convergence is consistent.Specific method is first to draw the vertical curve along centrum center position, then, is found by intervertebral foramen
The oblique line of heart position, both sides oblique line should be symmetrical, i.e., be in same angle with vertical curve.Then line normal thereto is drawn on oblique line
Section 4, is about 2mm, and central point is located on oblique line, and the spacing of every line segment is 3mm, most inner side line segment and canalis spinalis dural sac away from
From being also 3mm, oblique line is connected with dural sac intersection point and each line segment terminal, as region of interest.Calculate drawn interested
The number of fibre bundle and fiber tractography figure is drawn in area.Fibre bundle is classified according to form（It see the table below 1- tables 4）.Take fibre
The transverse axis bitmap of beam is tieed up, the cross-sectional area of fibre bundle on CAD Survey Softwares measurement spike figure is hoped in utilization.
The form fractional statisticses of the fiber harness shape of table 1
The Ipsilateral of table 2 and strong nervus lateralis root fibre bundle number
The Ipsilateral of table 3 and strong nervus lateralis root fibre bundle area
The Ipsilateral of table 4 and strong nervus lateralis root fibre bundle form compare
The quality control of 4 scanning processes and image procossing
It is tested to lie on examination couch using unified localization method when being scanned to subject, by observing repeatedly（Check
Bed is observed before and after entering specified location）, make cephalocaudal axis parallel with main field major axis, in tested head, trunk
Heart line is corrected, so as to reach the standardization of scan position.
When delineating region of interest, multiple delineate with so that region meets above-mentioned standard is carried out.And use same position
The cross-sectional view put, is measured.When measuring area using CAD software, by pattern visual evoked potentials, to cause area measurement accurate.
5 statistical analyses
Statistical analysis uses the softwares of SAS 9.0.Root compression side is caused to be referred to as Ipsilateral, nerve root non-compression-side intervertebral disc degeneration
Referred to as it is good for side.Compare whether Ipsilateral, number, area, the form of strong nervus lateralis root fibre bundle have significant difference.If data are in just
State is distributed, then using the matched-pair design t methods of inspection；If data are in Non-Gaussian Distribution, entered using matched-pair design non-parametric test
Row compares, P<0.05 is with statistical significance.
6 results
6.1 Ipsilaterals, strong nervus lateralis root fibre bundle number compare
Ipsilateral meets normal distribution with strong nervus lateralis root fibre bundle number, but its difference does not meet normal distribution, therefore uses
Non-parametric test method carries out statistical analysis.Analysis result shows Ipsilateral and strong nervus lateralis root fibre bundle number no statistical difference
Meaning.
6.2 Ipsilaterals, strong nervus lateralis root fibre bundle Area comparison
Ipsilateral does not meet normal distribution with strong nervus lateralis root fibre bundle area, therefore is counted using non-parametric test method
Analysis.Analysis result shows that Ipsilateral and strong nervus lateralis root fibre bundle area discrepancy are statistically significant.
6.3 Ipsilaterals, strong nervus lateralis root fibre bundle form compare
Ipsilateral has statistical significance with strong nervus lateralis root fibre bundle morphological differences.The ridge being pressurized on nerve root fibers beam spike figure
Nerve root is typically shown as fibre bundle and loses integrality, relatively gathers, and does not show peripheral ramifications.And the spinal nerve root not being pressurized leads to
Normal fibre bundle is complete, natural shape, diverging, Chang Kejian peripheral ramificationses.(Fig. 2-7 be same patient, show waist 4-5 interverbebral discs to
Spinal nerve root at the bulging of centrum right back, extruding right side intervertebral foramen, DTI diagram lesion lateral ridge branching nerve roots are less than 5, form
Gather.According to above-mentioned region of interest system of selection, drawn region of interest is symmetrical, and reproducible, experimental result is reliable).
Finally it should be noted that：The above embodiments are merely illustrative of the technical solutions of the present invention, rather than its limitations；Although
The present invention is described in detail with reference to the foregoing embodiments, it will be understood by those within the art that：It still may be used
To be modified to the technical scheme described in previous embodiment, or equivalent substitution is carried out to which part technical characteristic；And
These modifications are replaced, and the essence of appropriate technical solution is departed from the spirit and model of technical scheme of the embodiment of the present invention
Enclose.
Claims (6)
1. a kind of radiculoneuropathy based on Diffusion Tensor Imaging becomes quantitative evaluation method, it is characterised in that it includes
Following steps：
Step 1：Sagittal plain T2WI and axle position T2WI sequence scannings are carried out first, find lesion spinal nerve root position, it is flat to lesion
Face carries out axle position DTI scannings, and DTI uses 3.0 T MRI single-shot spin echo plane imaging sequences（single shot-
spin echo planar imaging sequence）, obtain diffusion tensor view data；
Step 2：The region of interest of spinal nerve root Diffusion Tensor Imaging is determined, the system of selection of region of interest is as follows：Sense
Region of interest (region of interest, ROI) selects left and right sides intervertebral bore region, is symmetric the ROI of both sides,
And size convergence is consistent, specific method is first to draw the vertical curve along centrum center position, then, is found by intervertebral foramen
The oblique line of center, both sides oblique line should be symmetrical, i.e., be in same angle with vertical curve；
Then 4, line segment normal thereto is drawn on oblique line, a length of 2 ± 0.1mm, central point is located on oblique line, every line segment
Spacing be 3 ± 0.1mm, most the distance of inner side line segment and canalis spinalis dural sac is also 3 ± 0.1mm, by oblique line and dural sac intersection point
And each line segment end points is sequentially connected with, as region of interest；
Step 3：Data processing, calculates the number of the fibre bundle in drawn region of interest and draws fiber spike figure, based on determination
Property tracking fibre bundle algorithm Volume one softwares；
Step 4：Spinal nerve root Structure Quantification is evaluated.
2. a kind of radiculoneuropathy based on Diffusion Tensor Imaging according to claim 1 becomes quantitative assessment side
Method, it is characterised in that in step 1, DTI uses TR/TE：2300/75.5 ms, thickness 5mm do not have an interlamellar spacing, 256 ×
256 matrixes, FOV38 × 38mm.
3. a kind of radiculoneuropathy based on Diffusion Tensor Imaging according to claim 1 becomes quantitative assessment side
Method, it is characterised in that in step 1, DTI uses b values for 0 and 600 s/mm2, 6 directions.
4. a kind of radiculoneuropathy based on Diffusion Tensor Imaging according to claim 1 becomes quantitative assessment side
Method, it is characterised in that in step 1, sagittal plain T2WI parameters：TR2500ms, TE108.9ms；Axle position T2WI parameters：
TR2440ms, TE120.8ms.
5. a kind of radiculoneuropathy based on Diffusion Tensor Imaging according to claim 1 becomes quantitative assessment side
Method, it is characterised in that in step 3, anisotropy（Fractional anisotropy, FA）Threshold value is 0.18.
6. a kind of radiculoneuropathy based on Diffusion Tensor Imaging according to claim 1 becomes quantitative assessment side
Method, it is characterised in that method for quantitatively evaluating in step 4 is that fibre bundle form is divided into more than complete and imperfect, branch and divided
Branch is few, complete and branch is generally 2 points, and complete but branch is 1 point less, and many but imperfect branches are also 1 point, imperfect and branch is few
For 0 point, described branch is generally to be more than or equal to 5, and few described branch is less than 5.
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Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2019209018A (en) * | 2018-06-07 | 2019-12-12 | 洋司 西島 | Early diagnosis of dementia by brain MRI |
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| JP2019209018A (en) * | 2018-06-07 | 2019-12-12 | 洋司 西島 | Early diagnosis of dementia by brain MRI |
| JP7177429B2 (en) | 2018-06-07 | 2022-11-24 | 洋司 西島 | Early diagnosis of dementia by brain MRI examination |
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| CN116109571B (en) * | 2022-12-22 | 2024-04-26 | 浙江大学 | Automatic fiber bundle reconstruction method and system for facial auditory nerve |
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