CN110859623A - Image-based lumbar intervertebral foramen stenosis detection method - Google Patents
Image-based lumbar intervertebral foramen stenosis detection method Download PDFInfo
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- CN110859623A CN110859623A CN201911229792.9A CN201911229792A CN110859623A CN 110859623 A CN110859623 A CN 110859623A CN 201911229792 A CN201911229792 A CN 201911229792A CN 110859623 A CN110859623 A CN 110859623A
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- 208000031481 Pathologic Constriction Diseases 0.000 title claims abstract description 23
- 230000036262 stenosis Effects 0.000 title claims abstract description 23
- 208000037804 stenosis Diseases 0.000 title claims abstract description 23
- 238000001514 detection method Methods 0.000 title claims abstract description 10
- 210000005036 nerve Anatomy 0.000 claims abstract description 111
- 238000000034 method Methods 0.000 claims abstract description 17
- 206010025005 lumbar spinal stenosis Diseases 0.000 claims 2
- 208000005198 spinal stenosis Diseases 0.000 claims 2
- 238000003384 imaging method Methods 0.000 abstract description 2
- 238000001356 surgical procedure Methods 0.000 abstract description 2
- 238000002595 magnetic resonance imaging Methods 0.000 description 10
- 210000002517 zygapophyseal joint Anatomy 0.000 description 6
- 238000010586 diagram Methods 0.000 description 4
- 230000000694 effects Effects 0.000 description 3
- 210000001519 tissue Anatomy 0.000 description 3
- 238000003745 diagnosis Methods 0.000 description 2
- 210000003041 ligament Anatomy 0.000 description 2
- 230000001575 pathological effect Effects 0.000 description 2
- 238000002601 radiography Methods 0.000 description 2
- 238000000264 spin echo pulse sequence Methods 0.000 description 2
- 210000003594 spinal ganglia Anatomy 0.000 description 2
- 206010020880 Hypertrophy Diseases 0.000 description 1
- 206010061310 Nerve root injury Diseases 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 238000002583 angiography Methods 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 238000002591 computed tomography Methods 0.000 description 1
- 210000002808 connective tissue Anatomy 0.000 description 1
- 206010020718 hyperplasia Diseases 0.000 description 1
- 230000001969 hypertrophic effect Effects 0.000 description 1
- 210000004749 ligamentum flavum Anatomy 0.000 description 1
- 230000008092 positive effect Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 208000037920 primary disease Diseases 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 210000000273 spinal nerve root Anatomy 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 208000011580 syndromic disease Diseases 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
- A61B5/4538—Evaluating a particular part of the muscoloskeletal system or a particular medical condition
- A61B5/4566—Evaluating the spine
Abstract
An image-based lumbar intervertebral foramen stenosis detection method, comprising: nerve root coronal scanning, nerve root axial scanning and nerve root sagittal scanning; determining a nerve root coronal scanning positioning line in nerve root coronal scanning, performing lumbar intervertebral disc horizontal axis thin-layer scanning, determining a fusiform nerve root section at the posterior lateral edge of a vertebral body, wherein the positioning line is parallel to a fusiform long axis, the positioning line is parallel to the nerve root walking direction, and performing three-dimensional positioning adjustment; the axial scanning and positioning line of the nerve root is vertical to the long axis of the nerve root at the coronary position obtained in the above way, and the sagittal scanning and positioning line of the nerve root is parallel to the long axis of the nerve root at the coronary position obtained in the above way. Whether intervertebral foramen is narrow or not can be detected quickly and accurately, narrow tissue sources are caused, the detection process is noninvasive, quick and accurate, a new detection mode is provided for diagnosing intervertebral foramen narrow and nerve root variation, and accurate imaging basis is also provided for surgical treatment.
Description
Technical Field
The invention relates to the technical field of magnetic resonance examination, in particular to a method for detecting lumbar intervertebral foramen stenosis based on images.
Background
One of the common causes of lumbocrural pain is that lumbar spinal nerve roots are mechanically clamped and pressed, wherein lumbar spinal foraminal stenosis accounts for about 8% -11% of the nerve root clamping and pressing cause, and lumbar operation failure syndrome is related to omitted spinal foraminal stenosis or postoperative secondary spinal foraminal stenosis to a great extent.
The lumbar intervertebral foramen is composed of two parts, namely a bony canal and connective tissues (mainly ligaments) inside and outside the canal. At present, the boundary of the lumbar intervertebral foramen is not finally determined, and the result of the image study is different because the anatomical structure of the intervertebral foramen is more complex. There are several methods for assessing lumbar spinal foraminal stenosis: lateral and dynamic flexion-extension X-ray films can show intervertebral foramen, but false positive appears due to the position deviation of the lower lumbar intervertebral foramen; the value of the spinal canal radiography for diagnosing the central spinal canal stenosis is larger, but the epidural sac is stopped at the outer edge of the central area of the lateral spinal canal, so that the nerve roots at the more outer side cannot be displayed, and the diagnosis effect on the lateral intervertebral foramina stenosis is limited; CT scanning can only predict whether the intervertebral foramen is narrow according to the hyperplasia and hypertrophy of the facet joints (namely the narrow degree of lateral crypt), and the trend and the shape of nerves in the intervertebral foramen cannot be displayed; the lumbar nerve root radiography can know the form and the walking condition of nerve roots in intervertebral holes, but the operation is complex, invasive examination is performed, and the clinical popularization and application are influenced; epidural angiography under pressure can show intervertebral foramen, but is also invasive examination with false positive interference; the nerve root blocking method is very useful for judging whether the nerve is related to clinical symptoms, but has no identification effect on primary diseases, cannot judge the diseased part of the nerve root, and has the risk of nerve root injury.
The conventional magnetic resonance examination is an effective method for detecting lumbar intervertebral foramen stenosis and judging the stenosis degree, and the conventional magnetic resonance scanning mode can clearly display lumbar intervertebral foramen bony pipelines and soft tissue channels, but can not display nerve root running and form in the whole process, and has limited effect on positioning diagnosis of intervertebral foramen stenosis.
Disclosure of Invention
The invention aims to provide a method for detecting lumbar intervertebral foramen stenosis based on images.
The technical scheme adopted by the invention for solving the technical problems in the prior art is as follows:
the invention discloses an image-based lumbar intervertebral foramen stenosis detection method, which comprises the following steps: nerve root coronal scanning, nerve root axial scanning and nerve root sagittal scanning; determining a nerve root coronal scanning positioning line in nerve root coronal scanning, performing lumbar intervertebral disc horizontal axis thin-layer scanning, determining a 'fusiform' nerve root section at the rear outer side edge of a vertebral body, wherein the positioning line is parallel to a fusiform long axis, adjusting the inclination angle of the positioning line, ensuring that the positioning line is parallel to the long axis of the 'fusiform' nerve root section seen in each axial thin-layer scanning layer, namely parallel to the nerve root walking direction, and performing three-dimensional positioning adjustment; the axial scanning and positioning line of the nerve root in the axial scanning of the nerve root is vertical to the long axis of the obtained coronary nerve root, and the scanning range comprises the whole walking process before the nerve root enters the intervertebral foramen and after the nerve root exits the intervertebral foramen; in the nerve root sagittal scan, a nerve root sagittal scan positioning line is parallel to the acquired long axis of the nerve root in the coronary position.
The invention can also adopt the following technical measures:
the magnetic resonance scanning adopts a 1.5T superconducting magnetic resonance scanner of Siemens to carry out spin echo sequence scanning.
In the nerve root coronal scanning and the nerve root sagittal scanning, the SE sequence: t1 weighted scan, TR350 ms, TE13 ms, echo train length ET equal to 3, layer thickness 2 mm, layer spacing 0.2 mm, scan 7 layers; t2 weighted scan, TR 3000ms, TE123 ms, ET 25, with the same number of scan layers and positioning as the T1 weighted scan; in the nerve root axis scanning, SE sequence: t2 weighted scan, TR3500 ms, TE 129ms, ET 25, scan 11 layers, layer thickness 4 mm, layer spacing 0.4 mm; t1 weighted scan, TR518 ms, TE12 ms, ET 3, the number of scan layers and positioning is the same as for T2 weighted scan.
The invention has the advantages and positive effects that:
according to the image-based lumbar intervertebral foramen stenosis detection method, nerve root coronal scanning, nerve root sagittal scanning and nerve root axial magnetic resonance scanning of lumbar vertebrae are respectively adopted, whether intervertebral foramen is narrow or not and the tissue source causing the stenosis can be detected quickly and accurately, the detection process is non-invasive, quick and accurate, a new detection mode is provided for diagnosing intervertebral foramen stenosis and nerve root variation, and an accurate imaging basis is also provided for surgical treatment.
Drawings
FIG. 1 is a schematic diagram of the scanning and positioning of the coronal nerve root in the method for detecting lumbar intervertebral foraminal stenosis based on images according to the present invention;
FIG. 2 is a schematic diagram of axial scanning of nerve roots in the method for detecting lumbar intervertebral foraminal stenosis according to the present invention;
FIG. 3 is a schematic diagram of a nerve root sagittal scan in the method for detecting lumbar intervertebral foraminal stenosis according to the present invention;
FIG. 4 is a comparison of magnetic resonance imaging of a normal nerve root coronal scan and a diseased nerve root coronal scan;
FIG. 5 is a contrast image of magnetic resonance imaging of a normal nerve axial scan and a diseased nerve root axial scan;
figure 6 is a comparison of magnetic resonance imaging of a normal nerve root sagittal scan and a diseased nerve root sagittal scan.
The technical solution of the present invention is explained in detail by the accompanying drawings and the specific embodiments.
As shown in fig. 1 to 3, the method for detecting lumbar intervertebral foramen stenosis according to the present invention includes: nerve root coronal scanning, nerve root axial scanning and nerve root sagittal scanning; determining a nerve root coronal scanning positioning line in nerve root coronal scanning, performing lumbar intervertebral disc horizontal axis thin-layer scanning, determining a 'fusiform' nerve root section at the rear outer side edge of a vertebral body, wherein the positioning line is parallel to a fusiform long axis, adjusting the inclination angle of the positioning line, ensuring that the positioning line is parallel to the long axis of the 'fusiform' nerve root section seen in each axial thin-layer scanning layer, namely parallel to the nerve root walking direction, and performing three-dimensional positioning adjustment; the axial scanning and positioning line of the nerve root in the axial scanning of the nerve root is vertical to the long axis of the obtained coronary nerve root, and the scanning range comprises the whole walking process before the nerve root enters the intervertebral foramen and after the nerve root exits the intervertebral foramen; in the nerve root sagittal scan, a nerve root sagittal scan positioning line is parallel to the acquired long axis of the nerve root in the coronary position.
Magnetic resonance scanning spin echo sequence scans were performed using a 1.5T superconducting magnetic resonance scanner from siemens.
In the nerve root coronal scan and the nerve root sagittal scan, SE sequence: t1 weighted scan, TR350 ms, TE13 ms, echo train length ET 3, layer thickness 2 mm, layer spacing 0.2 mm, scan 7 layers; t2 weighted scan, TR 3000ms, TE123 ms, ET 25, with the same number of scan layers and positioning as the T1 weighted scan; in the nerve root axis scanning, SE sequence: t2 weighted scan, TR3500 ms, TE 129ms, ET 25, scan 11 layers, layer thickness 4 mm, layer spacing 0.4 mm; t1 weighted scan, TR518 ms, TE12 ms, ET 3, the number of scan layers and positioning is the same as for T2 weighted scan.
As shown in fig. 4, wherein a is MRI of normal nerve root coronal position, T2 is weighted like L4 nerve root is sent out from the dural sac to the full travel form outside the intervertebral foramen, L4 nerve root is tightly attached to the lower edge of L4 pedicle of vertebral arch to pass through the intervertebral foramen in smooth curve form, and the most swollen part of nerve root is the spinal ganglion and is located in the intervertebral foramen; the b picture is MRI of pathological nerve root coronal position, T2 weighted image shows that L4 nerve root is pressed, the nerve root walking is changed in bending, the area of the axillary triangle fat area of L4 nerve root becomes smaller, and intervertebral disc tissue protrudes into intervertebral foramen to press nerve root and spinal ganglion.
As shown in fig. 5, wherein a is normal nerve root axis MRI, T2 weighted image shows the nerve root is located on the upper position in the intervertebral foramen, the upper part is the pedicle of vertebral arch, the front part is the posterior and outer inferior border of superior vertebral body and intervertebral disc, the back part is the facet joint and the medial surface yellow ligament of the facet joint, and fat gap exists between the nerve root and the surrounding tissue; and b, an MRI (axial magnetic resonance imaging) of the diseased nerve root is shown, and a T2 weighted image shows that the L5 nerve root is pressed by a facet joint, a hypertrophic ligamentum flavum and a front intervertebral disc which are proliferated behind an intervertebral foramen and is tightly attached to the lower edge of a pedicle of vertebral arch, and a fat gap between the nerve root and the pedicle of vertebral arch disappears.
As shown in fig. 6, the a diagram is a normal nerve root sagittal MRI T2 weighted image showing the nerve root clinging to the posterior intervertebral facet joint and the anterior vertebral body passing through the intervertebral foramen, like a tadpole tail; the b picture is pathological nerve root sagittal MRI, T2 weighted image shows that the nerve root is pressed by the posterior intervertebral facet joint when passing through the intervertebral foramen, and the nerve root is bent and discontinuous.
Although the present invention has been described with reference to the preferred embodiments, it should be understood that various changes, substitutions and alterations can be made herein without departing from the spirit and scope of the invention as defined by the appended claims.
Claims (3)
1. An image-based lumbar intervertebral foramen stenosis detection method, comprising: nerve root coronal scanning, nerve root axial scanning and nerve root sagittal scanning; determining a nerve root coronal scanning positioning line in nerve root coronal scanning, performing lumbar intervertebral disc horizontal axis thin-layer scanning, determining a 'fusiform' nerve root section at the rear outer side edge of a vertebral body, wherein the positioning line is parallel to a fusiform long axis, adjusting the inclination angle of the positioning line, ensuring that the positioning line is parallel to the long axis of the 'fusiform' nerve root section seen in each axial thin-layer scanning layer, namely parallel to the nerve root walking direction, and performing three-dimensional positioning adjustment; the axial scanning and positioning line of the nerve root in the axial scanning of the nerve root is vertical to the long axis of the obtained coronary nerve root, and the scanning range comprises the whole walking process before the nerve root enters the intervertebral foramen and after the nerve root exits the intervertebral foramen; in the nerve root sagittal scan, a nerve root sagittal scan positioning line is parallel to the acquired long axis of the nerve root in the coronary position.
2. The method of claim 1, wherein the step of detecting the lumbar spinal stenosis includes: the magnetic resonance scan described above was performed using a 1.5T superconducting magnetic resonance scanner from siemens.
3. The method of claim 2, wherein the step of detecting the lumbar spinal stenosis includes: in the nerve root coronal scan and the nerve root sagittal scan, SE sequence: t1 weighted scan, TR350 ms, TE13 ms, echo train length ET equal to 3, layer thickness 2 mm, layer spacing 0.2 mm, scan 7 layers; t2 weighted scan, TR 3000ms, TE123 ms, ET 25, with the same number of scan layers and positioning as the T1 weighted scan; in the nerve root axis scanning, SE sequence: t2 weighted scan, TR3500 ms, TE 129ms, ET 25, scan 11 layers, layer thickness 4 mm, layer spacing 0.4 mm; t1 weighted scan, TR518 ms, TE12 ms, ET 3, the number of scan layers and positioning is the same as for T2 weighted scan.
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| CN112401869A (en) * | 2020-11-19 | 2021-02-26 | 苏州大学附属第一医院 | Magnetic resonance scanning method and related device |
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| US20080312660A1 (en) * | 2007-06-15 | 2008-12-18 | Baxano, Inc. | Devices and methods for measuring the space around a nerve root |
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