目的：探讨3.0 T MR扩张张量成像（DTI）及纤维束示踪成像（DTT）的部分各向异性（FA）值对放射性腰腿痛定量分析的价值。方法将40例无症状志愿者（A组）与48例放射性腰腿痛病人（B组）的MRI和临床资料分成4组，分别为无症状有椎间盘突出组（A1组，6例）、无症状无椎间盘突出组（A2组，34例）、有症状有椎间盘突出组（B1组，36例）和有症状无椎间盘突出组（B2组，12例），定量分析L4至S1神经根的平均FA值，采用t检验比较组间神经根的平均FA值的差异；采用ROC曲线分析神经根的FA值诊断椎间盘突出的阈值、敏感度、特异度和曲线下面积（AUC）；相关性分析采用Pearson相关。结果 A1组的FA值为0.213±0.003，略低于A2组的0.215±0.009，但组间FA值差异无统计学意义（t=0.628，P＞0.05）；而B1组的FA值为0.190±0.010，明显低于B2组的0.207±0.009（t=5.044，P＜0.01）。ROC曲线分析显示FA值≤0.197时，诊断椎间盘突出的AUC、敏感度和特异度分别为0.886、70.7%和91.5%。相关分析结果显示神经根FA值与椎间盘突出呈中等负相关（r=-0.652, P＜0.0001）。结论 MR DTI及DTT技术的FA值有助于临床对放射性腰腿痛的定量评估。
Objective Using quantitative analysis diffusion tensor imaging (DTI) and diffusion tensor tractography ( DTT ) to assess the clinical value of fractional anisotropy ( FA ) in radiating leg pain . Methods The clinical and MR examination data of 40 volunteers and 48 patients with radiating leg pain were divided into four groups:volunteers without clinical symptomatic but with disc hertiation (A1 group, n=6), volunteers without clinical symptomatic and without disc hertiation (A2 group, n=34), patients with clinical symptomatic and with disc hertiation (B1 group, n=36), patients with clinical symptomatic and without disc hertiation (B2 group, n=12). The mean FA values of L4, L5 and S1 nerve roots were calculated from DTI and DTT. The t test was used to evaluate the statistical significance. Receiver operating characteristic (ROC) curve analysis was performed for the evaluation of the sensitivity, specificity, and area under ROC curve (AUC). Pearson correlation analysis test was used to analyze correlation between the FA values of the nerve root and the intervertebral disc herniation. Results The mean FA value of the A1 group was lower than the A2 group (0.213± 0.003 vs. 0.215±0.009), but did not reach the significant level (t=0.628, P>0.05). The mean FA value of the B1 group was significantly lower than the B2 group (0.190 ±0.010 vs. 0.207 ±0.009, t=5.044, P<0.01). ROC curve analysis showed the AUC value, sensitivity, and specificity in diagnosing disc herniation were 0.886, 70.7%, and 91.5%, respectively when the FA value was less than 0.197. The results of correlation analysis showed that there was a medium negative correlation between the FA values of the nerve root and the intervertebral disc herniation (r=-0.652, P<0.000 1). Conclusion The FA value calculated from DTI and DTT at 3.0 T MRI could help clinical quantitative assessment in patients of radiating leg pain.
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