磁共振3D-SPACE神经成像显示腰骶丛肿瘤性病变的价值

摘要/Abstract

摘要：

目的：探讨三维可变翻转角快速自旋回波序列（three dimensional sampling perfection with application optimized contrasts by using different flip angle evolution，3D-SPACE）神经成像技术显示腰骶丛肿瘤性病变的价值。方法：回顾性分析2018年1月至2023年12月间16例累及腰骶丛神经的肿瘤性病变患者的MRI资料，所有病例均经病理检查确诊。测量病灶的最大径，统计病灶数目，观察病变累及的腰骶丛神经位置，统计受累神经数目，描述肿瘤与神经间的关系。结果：16例患者中，单发病灶10例，多发病灶6例，病灶平均最大径为（57.1±37.2） mm。累及单根神经5例，累及多根神经11例。肿瘤与神经关系，沿神经生长5例，神经受压5例，神经受肿瘤侵袭、包绕6例。结论：3D-SPACE神经成像技术能清晰、直观地显示受累神经的位置、数目及肿瘤与神经间的关系，在显示腰骶丛肿瘤性病变的定位及诊断中具有重要价值。

关键词:腰骶丛,磁共振神经成像,肿瘤性病变

Abstract:

ObjectiveTo investigate the value of the magnetic resonance neurography three-dimensional sampling perfection with application optimized contrasts by using different flip angle evolution (3D-SPACE) in displaying the neoplasms of the lumbosacral plexus.MethodsMRI 3D-SPACE images of 16 cases with neoplasm in the lumbosacral plexus collected during January 2018 to December 2023 were retrospectively analyzed. All cases were confirmed by pathology. The maximum diameter of the tumors was measured and the number of lesions was counted. The location of the involved lumbosacral plexus was observed and the number of the involved nerves was counted. The relationship between the tumors and nerves was evaluated.ResultsTen cases were of single lesion and 6 cases were of multiple lesions. The average maximum diameter of tumors was （57.1±37.2）mm. Single nerve involved was detected in 5 cases while multiple nerves involved were in 11 cases. The relationship between the tumor and nerve was divided into three types. The tumor grew along the nerve in 5 cases. The nerves were compressed by the tumors in 5 cases, and were invaded and surrounded in 6 cases.ConclusionsMRI 3D-SPACE can reveal the location and numbers of the tumor, displaying the relationship between the tumor and nerve clearly and intuitively, which is important for localization and diagnosis of the neoplastm in the lumbosacral plexus.

Key words:Lumbosacral plexus,Magnetic resonance neurography,Neoplastic lesion

中图分类号:

刘伟, 林光武, 李仕红. 磁共振3D-SPACE神经成像显示腰骶丛肿瘤性病变的价值[J]. 诊断学理论与实践, 2024, 23(02): 126-130.

LIU Wei, LIN Guangwu, LI Shihong. The value of magnetic resonance neurography 3 D-STIR-SPACE sequence in displaying neoplasms of the lumbosacral plexus[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(02): 126-130.

图/表4

图1

图2

图3

图4

参考文献12

[1]	CHHABRA A, LEE P P, BIZZELL C, et al. 3 Tesla MR neurography--technique, interpretation, and pitfalls[J].Skeletal Radiol,2011,40(10):1249-1260. doi:10.1007/s00256-011-1183-6pmid:21547613
[2]	吕银章, 翟恒. 臂丛神经损伤的MR诊断[J].实用放射学杂志,2016,32(12):1967-1969.
	LÜ Y Z, ZHAI H. MR diagnosis of brachial plexus injury[J].J Pract Radiol,2016,32(12):1967-1969.
[3]	巴伟丽, 刘学焕, 朱如森, 等. 腰椎间盘突出症神经根及神经节受累的磁共振神经成像研究[J].临床放射学杂志,2022,41(4):699-704.
	BA W L, LIU X H, ZHU R S, et al. Magnetic resonance neurography study of nerve root and ganglion compression in lumbar disc herniation[J].J Clin Radiol,2022,41(4):699-704.
[4]	SU X, KONG X, LU Z, et al. Use of magnetic resonance neurography for evaluating the distribution and patterns of chronic inflammatory demyelinating polyneuropathy[J].Korean J Radiol,2020,21(4):483-493. doi:10.3348/kjr.2019.0739pmid:32193896
[5]	邓明, 王承缘, 朱文珍, 等. 3.0T MR骶神经成像在神经源性膀胱病因探究中的价值[J].放射学实践,2017,32(1):62-67.
	DENG M, WANG C Y, ZHU W Z, et al. MRI of sacral plexus: a feasible study to detect the etiological factors of neurogenic bladder[J].Radiol Pract,2017,32(1):62-67.
[6]	吕银章, 翟恒, 孔祥泉, 等. 磁共振神经成像在外周神经鞘膜瘤的应用研究[J].磁共振成像,2015(12):922-926.
	LÜ Y Z, ZHAI H, KONG X Q, et al. Application study of magnetic resonance neurography in imaging of peripheral nerve sheath tumor[J].Chin J Magn Reson Imaging,2015(12):922-926.
[7]	CHHABRA A, THAKKAR RS, ANDREISEK G, et al. Anatomic MR imaging and functional diffusion tensor ima-ging of peripheral nerve tumors and tumorlike conditions[J].Am J Neuroradiol,2013,34(4):802-807.
[8]	费佳, 翁得河, 赵聪, 等. Syngo MR外周神经成像[J].磁共振成像,2012,3(6):465-470.
	FEI J, WEN D H, ZHAO C, et al. Syngo MR peripheral nerve imaging[J].Chin J Magn Reson Imaging,2012,3(6):465-470.
[9]	许桂晓, 彭康强, 张卫东, 等. 增强3D SPACE STIR 序列在显示腰骶神经根中的应用价值[J].中华临床医师杂志(电子版),2013(6):2497-2500.
	XU G X, PENG K Q, ZHANG W D, et al. Application of enhanced 3D SPACE STIR sequence to display lumbosacral plexus[J].Chin J Clin(Electron Ed),2013(6):2497-2500.
[10]	李晓琴, 何欣, 宋丽娟, 等. 乳腺浸润性导管癌神经侵犯的临床病理分析[J].临床与实验病理学杂志,2020,36(3):329-332.
	LI X Q, HE X, SONG L J, et al. Clinical and pathologic analysis in the nerver invasion by the breast ductal carcinoma[J].Chin J Clin Exp Pathol,2020,36(3):329-332.
[11]	余裕珍, 洪桂洵, 杨智云. 颞骨原发性恶性肿瘤颅神经侵犯的CT与MR影像学评估[J].中华解剖与临床杂志,2020,25(6):612-616.
	YU Y Z, HONG G X, YANG Z Y, et al. CT and MRI evaluation of cranial nerve invasion in temporal primary malignant tumors[J].Chin J Anat Clin,2020,25(6):612-616.
[12]	俞婕妤, 周健, 李娜, 等. 基于多排螺旋CT的胰腺导管腺癌神经浸润评分与胰腺外神经侵犯的关系[J].中华胰腺病杂志,2021,21(6):455-460.
	YU J Y, ZHOU J, LI N, et al. Relationship between perineural invasion scores based on multidetector computed tomography and extrapancreatic perineural invasion in pancreatic ductal adenocarcinoma[J].Chin J Pancreatol,2021,21(6):455-460.