标题：MR 3D-FIESTA序列对腰椎间盘突出症腰骶神经根受压程度的评估价值

      作者：罗维斯，董斐然，刘志方    韶关市中医院放射科，广东 韶关 512026

      卷次： 2022年33卷14期

      【摘要】 目的 探究MR 3D-FIESTA序列对腰椎间盘突出症腰骶神经根受压程度的评估价值。方法 选择2019年10月至2021年4月韶关市中医院收治的120例因腰椎间盘突出致腰腿痛的患者为研究对象，所有患者分别行常规序列、三维双激发平衡式稳态自由进动(3D-FIESTA)序列、迭代最小二乘估算法水脂分离技术(IDEAL)序列扫描。从受压神经显示清晰度、图像质量和对比噪声比方面比较 3D-FIESTA序列和 IDEAL序列的成像效果。结果 3D-FIESTA序列显示腰骶神经根、受压神经根上的清晰度评分分别为(4.64±0.76)分、(4.51±0.64)分，明显高于 IDEAL序列的(4.01±0.53)分、(3.89±0.51)分，差异均有统计学意义(P<0.05)；IDEAL序列能够清晰显示椎间盘图像，而3D-FIESTA序列重建图像除了能够清晰显示椎间盘图像外，还能清晰显示脊神经与椎间盘的空间位置关系；3D-FIESTA序列、IDEAL序列的图像质量分级比例Ⅰ~Ⅲ级分别为 75.83%、22.50%、1.67%和 51.67%、37.50%、10.83%，3D-FIESTA序列的图像质量分级明显优于 IDEAL序列，差异有统计学意义(P<0.05)；3D-FIESTA序列的腰骶神经根-椎体信噪比(SNR)、腰骶神经根-椎体载噪比(CNR)分别为51.46±6.46、36.09±5.71，明显低于IDEAL序列的117.25±18.03、73.26±9.86，腰骶神经根-脑脊液SNR、腰骶神经根-脑脊液CNR分别为269.18±28.48、284.23±21.77，明显高于IDEAL序列的216.26±20.43、103.57±14.79，差异均有统计学意义(P<0.05)。结论 3D-FIESTA序列能够清晰显示脊神经的形态、走行及其与腰椎间盘的相对空间关系，对于腰椎间盘突出症腰骶神经根受压程度的诊断和评估具有重要指导意义。
      【关键词】 腰椎间盘突出；腰骶神经根受压；三维双激发平衡式稳态自由进动序列；迭代最小二乘估算法水脂分离技术序列
      【中图分类号】 R681.5+3 【文献标识码】 A 【文章编号】 1003—6350（2022）14—1835—04

Application value of MR 3D-FIESTA sequence in evaluating the compression degree of lumbosacral nerve rootin lumbar disc herniation.
LUO Wei-si, DONG Fei-ran, LIU Zhi-fang. Department of Radiology, Shaoguan Hospital ofTraditional Chinese Medicine, Shaoguan 512026, Guangdong, CHINA
【Abstract】 Objective To study the application value of MR three-dimensional double excitation balancedsteady-state free precession (3D-FIESTA) sequence in evaluating the compression degree of lumbosacral nerve root inlumbar disc herniation. Methods A total of 120 patients with lumbar and leg pain caused by lumbar disc herniation inShaoguan Hospital of Traditional Chinese Medicine from October 2019 to April 2021 were selected as the research ob-jects. All patients were scanned with conventional sequence, 3D-FIESTA sequence, and iterative decomposition of wa-ter and fat with echo asymmetry and least-squares estimation (IDEAL) sequence. The imaging results of 3D-FIESTAsequence and IDEAL sequence were compared in terms of display clarity, image quality, and contrast to noise ratio.