背景:腰骶部神经根疼痛的诊断仍然具有挑战性。扩散张量成像(DTI)和扩散加权成像(DWI)有可能定量评价症状神经根,这可能有助于诊断。
目的:为了确定DTI和DWI指标的能力,即分数各向异性(FA)和表观扩散系数(ADC),区分健康和有症状的腰骶神经根,为了评估FA和ADC值与患者症状之间的关联,并确定FA和ADC的可靠性。
方法:系统评价。
方法:伴有或不伴有神经根病的神经根性疼痛患者由肌肉骨骼相关压迫或炎症引起,单侧腰骶神经根和来自29项研究的244名健康对照。
■1.5T或3T时的扩散加权回波平面成像序列
结果:在Embase,Scopus,和Medline数据库。提取症状性及对侧腰骶神经根的FA值和ADC值,以及评估者内部和评估者之间的协议。如有,我们提取了DWI或DTI参数与患者症状或症状持续时间之间的关联.
方法:对纳入研究的主要结果进行总结。没有进行额外的统计分析。
结果:DTI研究系统地发现,患有或不患有神经根病的神经根疼痛患者的症状和对侧腰骶神经根的FA值存在显着差异。相比之下,DTI和DWI研究对有症状的神经根的识别与ADC值不一致.FA值与几种症状中度至强相关(例如,残疾,神经功能障碍,和症状持续时间)。DTI参数的评估者间和评估者内可靠性中等至优异。纳入研究的方法学质量差异很大。
结论:本系统评价显示,DTI是一种可靠的鉴别成像技术,可用于评估有症状的腰骶神经根,比DWI更一致地识别有症状的神经根。需要进一步的高质量研究来证实这些结果。
方法:不适用技术效率:第二阶段。
BACKGROUND: Lumbosacral radicular pain diagnosis remains challenging. Diffusion tensor imaging (DTI) and diffusion weighted imaging (DWI) have potential to quantitatively evaluate symptomatic nerve root, which may facilitate diagnosis.
OBJECTIVE: To determine the ability of DTI and DWI metrics, namely fractional anisotropy (FA) and apparent diffusion coefficient (ADC), to discriminate between healthy and symptomatic lumbosacral nerve roots, to evaluate the association between FA and ADC values and patient symptoms, and to determine FA and ADC reliability.
METHODS: Systematic
review.
METHODS: Eight hundred twelve patients with radicular pain with or without radiculopathy caused by musculoskeletal-related compression or inflammation of a single, unilateral lumbosacral nerve root and 244 healthy controls from 29 studies.
UNASSIGNED: Diffusion weighted echo planar imaging sequence at 1.5 T or 3 T.
RESULTS: An extensive systematic
review of the literature was conducted in Embase, Scopus, and Medline databases. FA and ADC values in symptomatic and contralateral lumbosacral nerve roots were extracted and summarized, together with intra- and inter-rater agreements. Where available, associations between DWI or DTI parameters and patient symptoms or symptom duration were extracted.
METHODS: The main results of the included studies are summarized. No additional statistical analyses were performed.
RESULTS: The DTI studies systematically found significant differences in FA values between the symptomatic and contralateral lumbosacral nerve root of patients suffering from radicular pain with or without radiculopathy. In contrast, identification of the symptomatic nerve root with ADC values was inconsistent for both DTI and DWI studies. FA values were moderately to strongly correlated with several symptoms (eg, disability, nerve dysfunction, and symptom duration). The inter- and intra-rater reliability of DTI parameters were moderate to excellent. The methodological quality of included studies was very heterogeneous.
CONCLUSIONS: This systematic
review showed that DTI was a reliable and discriminative imaging technique for the assessment of symptomatic lumbosacral nerve root, which more consistently identified the symptomatic nerve root than DWI. Further studies of high quality are needed to confirm these results.
METHODS: N/A TECHNICAL EFFICACY: Stage 2.