MRI检查神经根沉降征诊断LSS患者的价值及其危险因素分析

doi:10.7517/issn.1674-0475.210804

摘要/Abstract

摘要： 本研究探讨磁共振成像（MRI）检查神经根沉降征（NRS）在腰椎管狭窄症（LSS）患者发生中的相关因素及其诊断学价值。选取接受腰椎MRI检查的262例（511个腰椎节段）患者进行研究，根据MRI结果患者腰椎节段分为狭窄组（172例患者，348个腰椎节段）和非狭窄组（90例患者，163个腰椎节段）。狭窄组硬膜囊面积（CSA）<100 mm²患者占比、椎管正中矢状径（PDA）≤15 mm患者占比、侧隐窝矢状径≤5 mm患者占比、神经根沉降征（NRS）阳性率均显著高于非狭窄组（P<0.05）；NRS诊断LSS的曲线下面积（AUC）值为0.714；172例LSS患者，NRS阳性患者108例、NRS阴性患者64例，NRS阳性组的糖尿病率、硬膜囊CSA<100 mm²患者占比、椎管PDA≤15 mm患者占比、侧隐窝矢状径≤5 mm患者占比均高于阴性组患者，差异均具有统计学意义（P<0.05）；硬膜囊CSA<100 mm²、椎管PDA≤15 mm、侧隐窝矢状径≤5 mm是LSS患者发生NRS的独立危险因素（P<0.05）。NRS对于诊断LSS具有较高的特异度，但是灵敏度一般，患者椎管狭窄越严重，其NRS发生的风险越高。

关键词: 磁共振成像, 神经根沉降征, 腰椎管狭窄症, 相关因素, 诊断

Abstract: This study explored the related factors and diagnostic value of nerve root subsidence (NRS) in patients with lumbar spinal stenosis (LSS) by magnetic resonance (MRI). 262 patients (511 lumbar segments) who underwent lumbar MRI examination were selected for the study. According to the MRI results, the lumbar segments of the patients were divided into a stenosis group (172 patients, 348 lumbar segments) and a non-stenosis group (90 patients, 163 lumbar segments). In the stenosis group, the proportion of patients with dural sac area (CSA) <100 mm², the proportion of patients with spinal canal median sagittal diameter (PDA) ≤ 15 mm, the proportion of patients with lateral recess sagittal diameter ≤ 5 mm, and nerve root subsidence (NRS) positive. The rates were significantly higher than those of the non-stenotic group (P<0.05). The AUC value of the area under the curve for the diagnosis of LSS by NRS was 0.714; 172 patients with LSS, 108 patients with NRS positive, 64 patients with NRS negative, the rate of diabetes in the NRS positive group, the proportion of patients with dural sac CSA<100 mm², spinal canal PDA ≤ the proportion of 15 mm patients and the proportion of patients with lateral recess sagittal diameter ≤ 5 mm were higher than those of the negative group, and the difference was statistically significant (P<0.05); dural sac CSA<100 mm², spinal canal PDA ≤ 15 mm, lateral recession the sagittal diameter of the fossa ≤ 5 mm is an independent risk factor for NRS in LSS patients (P<0.05). NRS has high specificity for the diagnosis of LSS, but the sensitivity is average. The more severe the spinal stenosis of the patient, the higher the risk of NRS.

Key words: magnetic resonance, nerve root subsidence sign, lumbar spinal stenosis, related factors, diagnosis

李敏红, 余林, 李志铭, 谭理连, 李汉文, 列潮炜, 利晞, 梁杰峰. MRI检查神经根沉降征诊断LSS患者的价值及其危险因素分析[J]. 影像科学与光化学, 2022, 40(1): 53-58.

LI Minhong, YU Lin, LI Zhiming, TAN Lilian, LI Hanwen, LIE Chaowei, LI Xi, LIANG Jiefeng. The Value of MRI in the Diagnosis of Nerve Root Subsidence in Patients with LSS and Analysis of Its Risk Factors[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(1): 53-58.

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