CN110859623B - Image-based lumbar intervertebral foramen stenosis detection method - Google Patents
Image-based lumbar intervertebral foramen stenosis detection method Download PDFInfo
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- 208000031481 Pathologic Constriction Diseases 0.000 title claims abstract description 26
- 230000036262 stenosis Effects 0.000 title claims abstract description 26
- 208000037804 stenosis Diseases 0.000 title claims abstract description 26
- 238000001514 detection method Methods 0.000 title abstract description 11
- 210000005036 nerve Anatomy 0.000 claims abstract description 109
- 238000000034 method Methods 0.000 claims abstract description 19
- 230000008569 process Effects 0.000 claims abstract description 5
- 238000000264 spin echo pulse sequence Methods 0.000 claims description 3
- 238000003384 imaging method Methods 0.000 abstract description 3
- 238000001356 surgical procedure Methods 0.000 abstract description 3
- 238000002595 magnetic resonance imaging Methods 0.000 description 8
- 210000002517 zygapophyseal joint Anatomy 0.000 description 6
- 238000003745 diagnosis Methods 0.000 description 3
- 210000003041 ligament Anatomy 0.000 description 3
- 230000004048 modification Effects 0.000 description 3
- 238000012986 modification Methods 0.000 description 3
- 210000001519 tissue Anatomy 0.000 description 3
- 206010010904 Convulsion Diseases 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000001575 pathological effect Effects 0.000 description 2
- 238000002601 radiography 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
- 210000003484 anatomy Anatomy 0.000 description 1
- 238000002583 angiography 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
- 230000004069 differentiation Effects 0.000 description 1
- 210000001951 dura mater Anatomy 0.000 description 1
- 230000001969 hypertrophic effect Effects 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 230000036285 pathological change Effects 0.000 description 1
- 231100000915 pathological change Toxicity 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
- 230000035755 proliferation Effects 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 230000008961 swelling Effects 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
A detection method of lumbar intervertebral foramen stenosis based on image comprises the following steps: nerve root coronal scan, nerve root axial scan, and nerve root sagittal scan; the method comprises the steps of determining nerve root coronal position scanning positioning lines in nerve root coronal position scanning, carrying out horizontal axis position thin-layer scanning on lumbar intervertebral disc, confirming a 'fusiform' nerve root section at the rear outer side edge of a vertebral body, enabling the positioning lines to be parallel to a fusiform long shaft, enabling the positioning lines to be parallel to the running direction of the nerve root, and carrying out three-dimensional positioning adjustment; the nerve root axial scanning positioning line is perpendicular to the obtained coronary nerve root long axis, and the nerve root sagittal scanning positioning line is parallel to the obtained coronary nerve root long axis. Can rapidly and accurately detect whether the intervertebral foramen is narrow or not and the tissue source causing the narrow, the detection process is noninvasive, rapid and accurate, a new detection mode is provided for diagnosing the intervertebral foramen narrow and nerve root variation, and an accurate imaging basis is provided for surgical treatment.
Description
Technical Field
The invention relates to the technical field of magnetic resonance examination, in particular to a detection method for lumbar intervertebral foramen stenosis based on images.
Background
One of the common causes of pain in the waist and lower extremities is mechanical seizures of the lumbar nerve root, wherein lumbar spinal foramen stenosis accounts for about 8% -11% of the reason of nerve root seizures, and lumbar surgery failure syndrome is largely related to missing spinal foramen stenosis or postoperative secondary foramen stenosis.
The lumbar intervertebral foramen consists of two parts, namely a bony duct and connective tissue (mainly ligaments) inside and outside the duct. At present, the boundary of the lumbar intervertebral foramen is not finally determined, and the imaging research results are different due to the complex anatomical structure of the intervertebral foramen. There are various methods for evaluating lumbar intervertebral foramen stenosis: although the lateral position and the dynamic flexion and extension position X-ray films can show intervertebral foramen, false positives occur due to the deflection of the position of the intervertebral foramen of the lower lumbar vertebra; the value of the angiography diagnosis of the central spinal canal stenosis is great, but the diagnosis of the lateral intervertebral foramen stenosis is limited because the dural sac is stopped at the outer edge of the central area of the lateral spinal canal and can not display more outer nerve roots; CT scan can only infer whether the intervertebral foramen is narrow according to the proliferation and hypertrophy of the facet joint (namely the stenosis degree of the side crypt), and the trend and the morphology of the nerves in the intervertebral foramen can not be displayed; the lumbar nerve root radiography can know the shape and the walking condition of the nerve root in the intervertebral foramen, but has complex operation and is an invasive examination, which affects the clinical popularization and application; epidural radiography under pressure can show intervertebral foramen, but is also a invasive examination and has false positive interference; the nerve root blocking method is very useful for judging whether the nerve is related to clinical symptoms, but has no differentiation effect on primary diseases, and cannot judge the pathological change part of the nerve root, and the nerve root injury risk exists.
The conventional magnetic resonance examination is an effective method for detecting lumbar intervertebral foramen stenosis and judging the stenosis degree, the conventional magnetic resonance scanning mode can clearly display lumbar intervertebral foramen osseous pipelines and soft tissue channels, but can not display the running and the form of nerve roots in the whole course, and has limited effect on positioning diagnosis of intervertebral foramen stenosis.
Disclosure of Invention
The invention aims to provide a detection method for 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 relates to a detection method of lumbar intervertebral foramen stenosis based on images, which comprises the following steps: nerve root coronal scan, nerve root axial scan, and nerve root sagittal scan; the method comprises the steps of determining nerve root coronal position scanning positioning lines in nerve root coronal position scanning, carrying out horizontal axial position thin-layer scanning on lumbar intervertebral disc, confirming a 'fusiform' nerve root section at the rear outer side edge of a vertebral body, enabling the positioning lines to be parallel to a fusiform long shaft, adjusting the inclination angle of the positioning lines, ensuring that the positioning lines are parallel to the long shaft of the 'fusiform' nerve root section seen in each axial position thin-layer scanning layer, namely parallel to the running direction of the nerve root, and carrying out three-dimensional positioning adjustment; the nerve root axial position scanning positioning line in the nerve root axial position scanning is perpendicular to the obtained coronary nerve root long axis, and the scanning range comprises the whole running process of the nerve root before entering the intervertebral foramen and after exiting the intervertebral foramen; the nerve root sagittal scan positioning line in the nerve root sagittal scan is parallel to the obtained coronary nerve root long axis.
The invention can also adopt the following technical measures:
the magnetic resonance scanning adopts a 1.5T superconducting magnetic resonance scanner of Siemens company to carry out spin echo sequence scanning.
In the nerve root coronal position scanning and the nerve root sagittal position scanning, the SE sequence is as follows: t1 weighted scan, TR 350 ms, te 13 ms, echo train length et=3, layer thickness 2 mm, layer spacing 0.2 mm, scan 7 layers; t2 weighted scan, TR 3000 ms,TE 123 ms,ET = 25, scan layer number and positioning the same as T1 weighted scan; in nerve root axial scan, SE sequence: t2 weighted scan, TR 3500 ms,TE 129ms,ET = 25, scan 11 layers, layer thickness 4 mm, layer spacing 0.4 mm; t1 weighted scan, TR 518 ms,TE 12 ms,ET =3, scan layer number and positioning are the same as T2 weighted scan.
The invention has the advantages and positive effects that:
In the detection method for lumbar intervertebral foramen stenosis based on the image, the nerve root coronal scanning, the nerve root sagittal scanning and the magnetic resonance scanning of the nerve root axial are respectively adopted, so that whether the intervertebral foramen is narrow or not and the tissue source causing the stenosis can be rapidly and accurately detected, the detection process is noninvasive, rapid and accurate, a new detection mode is provided for diagnosing the intervertebral foramen stenosis and nerve root variation, and an accurate imaging basis is provided for surgical treatment.
Drawings
FIG. 1 is a schematic view of the scanning and positioning of nerve root coronal position in the method for detecting lumbar intervertebral foramen stenosis based on images of the present invention;
FIG. 2 is a schematic view of axial scan of nerve roots in the method for detecting lumbar intervertebral foramen stenosis based on images according to the present invention;
FIG. 3 is a view showing nerve root sagittal scan in the method for detecting lumbar intervertebral foramen stenosis based on image of the present invention;
FIG. 4 is a contrast plot of magnetic resonance imaging of a normal nerve root coronal scan versus a diseased nerve root coronal scan;
FIG. 5 is a contrast plot of magnetic resonance imaging of a normal nerve axis scan versus a diseased nerve root axis scan;
Fig. 6 is a contrast image of a magnetic resonance image of a normal nerve root sagittal scan versus a diseased nerve root sagittal scan.
The technical scheme of the invention is described in detail below through the attached drawings and specific embodiments.
As shown in fig. 1 to 3, the method for detecting lumbar intervertebral foramen stenosis based on image of the present invention comprises: nerve root coronal scan, nerve root axial scan, and nerve root sagittal scan; the method comprises the steps of determining nerve root coronal position scanning positioning lines in nerve root coronal position scanning, carrying out horizontal axial position thin-layer scanning on lumbar intervertebral disc, confirming a 'fusiform' nerve root section at the rear outer side edge of a vertebral body, enabling the positioning lines to be parallel to a fusiform long shaft, adjusting the inclination angle of the positioning lines, ensuring that the positioning lines are parallel to the long shaft of the 'fusiform' nerve root section seen in each axial position thin-layer scanning layer, namely parallel to the running direction of the nerve root, and carrying out three-dimensional positioning adjustment; the nerve root axial position scanning positioning line in the nerve root axial position scanning is perpendicular to the obtained coronary nerve root long axis, and the scanning range comprises the whole running process of the nerve root before entering the intervertebral foramen and after exiting the intervertebral foramen; the nerve root sagittal scan positioning line in the nerve root sagittal scan is parallel to the obtained coronary nerve root long axis.
The magnetic resonance scan uses a siemens 1.5T superconducting magnetic resonance scanner to perform the spin echo sequence scan.
In the nerve root coronal scan and the nerve root sagittal scan, SE sequence: t1 weighted scan, TR 350 ms, te 13 ms, echo train length et=3, layer thickness 2 mm, layer spacing 0.2 mm, scan 7 layers; t2 weighted scan, TR 3000 ms,TE 123 ms,ET = 25, scan layer number and positioning the same as T1 weighted scan; in nerve root axial scan, SE sequence: t2 weighted scan, TR 3500 ms,TE 129ms,ET = 25, scan 11 layers, layer thickness 4mm, layer spacing 0.4 mm; t1 weighted scan, TR 518 ms,TE 12 ms,ET =3, scan layer number and positioning are the same as T2 weighted scan.
As shown in fig. 4, wherein the a-chart is a normal nerve root coronal MRI, the T2-weighted image shows the whole-course traveling form of the L4 nerve root emitted from the dura mater sac to the outside of the intervertebral foramen, the L4 nerve root passes through the intervertebral foramen in a smooth curve form against the lower edge of the L4 pedicle, and the nerve root swelling part is a spinal ganglion and is positioned in the intervertebral foramen; b, MRI of the coronary position of the pathological nerve root, T2 weighted image shows that the L4 nerve root is pressed, the nerve root is bent and changed, the area of the triangular fat area of the armpit of the L4 nerve root is reduced, and intervertebral disc tissue protrudes into the intervertebral foramen to press the spinal ganglion of the nerve root.
As shown in fig. 5, wherein the a-view is normal nerve root axial MRI, the T2-weighted image shows that nerve roots are located at an upper position in the intervertebral foramen, pedicles are located above, the front is the rear outer lower edge of the superior vertebral body and the intervertebral disc, the rear is the intervertebral facet joint and the yellow ligament on the inner side of the intervertebral facet joint, and fat gaps exist between the nerve roots and surrounding tissues; and b, the axial MRI of the pathological nerve root, wherein the T2 weighted image shows that the L5 nerve root is extruded by the facet joint, the hypertrophic yellow ligament and the anterior intervertebral disc which are proliferated behind the intervertebral foramen, is tightly attached to the lower edge of the vertebral pedicle, and the fat gap between the nerve root and the vertebral pedicle is disappeared.
As shown in fig. 6, wherein the a-view is a sagittal MRI T2-weighted image of a normal nerve root showing the nerve root in close proximity to the posterior intervertebral facet joint and the anterior vertebral body through the intervertebral foramen, resembling a "tadpole tail"; panel b shows a diseased nerve root sagittal MRI, with the T2-weighted image showing the nerve root being pressed by the posterior intervertebral facet joint as it passes through the intervertebral foramen, the nerve root being curved and discontinuous.
The present invention is not limited to the above-mentioned embodiments, but is not limited to the above-mentioned embodiments, and any person skilled in the art will make some changes or modifications to the above-mentioned embodiments without departing from the scope of the present invention, but any simple modification, equivalent changes and modifications to the above-mentioned embodiments according to the technical matter of the present invention fall within the scope of the technical matter of the present invention.
Claims (3)
1. The method for detecting lumbar intervertebral foramen stenosis based on image is characterized by comprising the following steps: nerve root coronal scan, nerve root axial scan, and nerve root sagittal scan; the method comprises the steps of determining nerve root coronal position scanning positioning lines in nerve root coronal position scanning, carrying out horizontal axial position thin-layer scanning on lumbar intervertebral disc, confirming a 'fusiform' nerve root section at the rear outer side edge of a vertebral body, enabling the positioning lines to be parallel to a fusiform long shaft, adjusting the inclination angle of the positioning lines, ensuring that the positioning lines are parallel to the long shaft of the 'fusiform' nerve root section seen in each axial position thin-layer scanning layer, namely parallel to the running direction of the nerve root, and carrying out three-dimensional positioning adjustment; the nerve root axial position scanning positioning line in the nerve root axial position scanning is perpendicular to the obtained coronary nerve root long axis, and the scanning range comprises the whole running process of the nerve root before entering the intervertebral foramen and after exiting the intervertebral foramen; the nerve root sagittal scan positioning line in the nerve root sagittal scan is parallel to the obtained coronary nerve root long axis.
2. The method for detecting lumbar intervertebral foramen stenosis based on image of claim 1, wherein: the above scan uses a Siemens 1.5T superconducting magnetic resonance scanner to perform spin echo sequence scanning.
3. The method for detecting lumbar intervertebral foramen stenosis based on image of claim 2, wherein: in the nerve root coronal scan and the nerve root sagittal scan, SE sequence: t1 weighted scan, TR 350ms, te 13ms, echo chain length et=3, layer thickness 2mm, layer spacing 0.2mm, scan 7 layers; t2 weighted scan, TR 3000ms,TE 123ms,ET = 25, scan layer number and positioning the same as T1 weighted scan; in nerve root axial scan, SE sequence: t2 weighted scan, TR 3500ms,TE 129ms,ET = 25, scan 11 layers, layer thickness 4mm, layer spacing 0.4mm; t1 weighted scan, TR 518ms, te 12ms, et=3, scan layer number and positioning are the same as T2 weighted scan.
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| CN103142230A (en) * | 2013-03-27 | 2013-06-12 | 深圳安科高技术股份有限公司 | Magnetic resonance positioning scanning method and device |
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| WO2008157513A1 (en) * | 2007-06-15 | 2008-12-24 | Baxano, Inc. | Devices and methods for measuring the space around a nerve root |
| US8394145B2 (en) * | 2010-02-24 | 2013-03-12 | Globus Medical | Expandable intervertebral spacer and method of posterior insertion thereof |
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| CN101606841A (en) * | 2009-07-10 | 2009-12-23 | 中国人民解放军第三军医大学第一附属医院 | A kind of MRI locating measurement method of human body optic tract shape |
| CN103142230A (en) * | 2013-03-27 | 2013-06-12 | 深圳安科高技术股份有限公司 | Magnetic resonance positioning scanning method and device |
| CN105496563A (en) * | 2015-12-04 | 2016-04-20 | 上海联影医疗科技有限公司 | Method for calibrating medical image positioning line |
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