Application of three-dimensional true fast imaging with steady-state precession sequence combined with diffusion tensor tractography for lumbar disc herniation / 中国介入影像与治疗学

ABSTRACT

Objective: To explore the value of three-dimensional true fast imaging with steady-state precession (3D-Ture FISP) sequence combined with diffusion tensor tractography (DTT) in determining the responsible nerve root of sciatica caused by lumbar disc herniation (LDH). Methods: MR examinations of lumbosacral region were performed on 40 LDH patients with unilateral sciatica (lesion group) and 40 healthy volunteers (control group). FA and ADC values of bilateral nerve roots were measured at L4-S1 vertebral level based on 3D-Ture FISP sequence and DTT fusing images. The responsible nerve roots of LDH patients with sciatica were detected combining with morphologic findings, course and FA and ADC values of the nerve roots shown on the fusing images. And statistical analysis was carried out. Results: All 3D-True FISP sequence and DTT fusing images could clearly show the morphology and course of nerve roots. In lesion group (51 involved nerve roots and 189 uninvolved nerve roots), 37 cases were found to be in accordance with the clinical symptoms whereas 3 cases were not. In control group (240 nerve roots), there was no statistical difference of FA and ADC values between the left and the right nerve roots (both P>0.05). The mean FA value of bilateral nerve roots was 0.346±0.042, and the mean ADC value was (1.296±0.080)mm2/s. The mean FA and ADC values of involved nerve roots in lesion group was 0.253±0.021 and (1.743±0.089)mm2/s, respectively. And the mean FA and ADC values of contralateral uninvolved nerve roots was 0.339±0.013 and (1.297±0.075)mm2/s, respectively. FA value of involved nerve roots in lesion group was significantly lower than that of contralateral uninvolved nerve roots in lesion group (t=0.806, P=0.038) and the mean FA value of control group (t=0.963, P=0.043), respectively,while ADC value significantly increased compared with contralateral uninvolved nerve roots (t=0.866, P=0.040) and control group (t=0.921, P=0.042). There was no statistical difference of the mean FA and ADC values between contralateral nerve roots in lesion group and control group (both P>0.05). Conclusion: 3D-Ture FLSP sequence combined with DTT technique can not only clearly show the anatomical morphology and course of nerve root, but also quantitatively detect the responsible nerve roots of sciatica in LDH patients, so as to provide information for clinical diagnosis and treatment.