Clinical applications of diffusion magnetic resonance imaging of the lumbar foraminal nerve root entrapment

European Spine Journal

Kazuyo Yamauchi³  Yawara Eguchi³  Hiroto Kamoda³  Yoshitada Masuda⁵  Gen Arai³  Takane Suzuki³  Munetaka Suzuki³  Sumihisa Orita³  Masashi Takaso⁴  Nobuyasu Ochiai³  Masayuki Miyagi³  Kazuhisa Takahashi³  Tomoaki Toyone¹  Yasuchika Aoki²  Tetsuhiro Ishikawa³  Masaomi Yamashita³  Takashi Kikawa⁵  Shigehiro Ochi⁵  Shunji Kishida³  Seiji Ohtori³ 

[1] Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan;Department of Orthopaedic Surgery, Chiba Rosai Hospital, 2-16 Tatsumidai-higashi, Ichihara, Chiba Japan;Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan;Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Kitasato1-15-1, Sagamihara, Kanagawa Japan;Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, Japan

关键词: Diffusion-weighted imaging;    Apparent diffusion coefficient;    Lumbar foraminal stenosis;    Magnetic resonance (MR) imaging;    Neurography;   

DOI  :  10.1007/s00586-010-1520-9

学科分类：骨科学

来源: Springer

【 摘 要 】

Diffusion-weighted imaging (DWI) can provide valuable structural information about tissues that may be useful for clinical applications in evaluating lumbar foraminal nerve root entrapment. Our purpose was to visualize the lumbar nerve root and to analyze its morphology, and to measure its apparent diffusion coefficient (ADC) in healthy volunteers and patients with lumbar foraminal stenosis using 1.5-T magnetic resonance imaging. Fourteen patients with lumbar foraminal stenosis and 14 healthy volunteers were studied. Regions of interest were placed at the fourth and fifth lumbar root at dorsal root ganglia and distal spinal nerves (at L4 and L5) and the first sacral root and distal spinal nerve (S1) on DWI to quantify mean ADC values. The anatomic parameters of the spinal nerve roots can also be determined by neurography. In patients, mean ADC values were significantly higher in entrapped roots and distal spinal nerve than in intact ones. Neurography also showed abnormalities such as nerve indentation, swelling and running transversely in their course through the foramen. In all patients, leg pain was ameliorated after selective decompression (n = 9) or nerve block (n = 5). We demonstrated the first use of DWI and neurography of human lumbar nerves to visualize and quantitatively evaluate lumbar nerve entrapment with foraminal stenosis. We believe that DWI is a potential tool for diagnosis of lumbar nerve entrapment.

【 授权许可】

Unknown