雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Neurological Surgery No Shinkei Geka Volume 38, Issue 3 （March 2010）

Neurological Surgery 脳神経外科 38巻3号（2010年3月発行）

Japanese English

研究

頚椎神経根診断におけるcurved coronal MPR imaging の有用性 Usefulness of Curved Coronal MPR Imaging for the Diagnosis of Cervical Radiculopathy 犬飼千景 ¹ , 犬飼崇 ¹ , 松尾直樹 ¹ , 清水郁男 ² , 五島久陽 ¹ , 高木輝秀 ¹ , 高安正和 ¹ Chikage INUKAi ¹ , Takashi INUKAI ¹ , Naoki MATSUO ¹ , Ikuo SHIMIZU ² , Hisaharu GOTO ¹ , Teruhide TAKAGI ¹ , Masakazu TAKAYASU ¹ ¹愛知医科大学医学部脳神経外科 ²愛知医大病院中央放射線部 ¹Depertment of Neurosurgery,Aichi Medical University ²Depertment of Centralradiology,Aichi Medical University Hospital キーワード： cervical radiculopathy , curved coronal MPR imaging , 3D MRI , cervical foraminal stenosis Keyword: cervical radiculopathy , curved coronal MPR imaging , 3D MRI , cervical foraminal stenosis pp.251-257

発行日 2010年3月10日 Published Date 2010/3/10

DOI https://doi.org/10.11477/mf.1436101125

PDF(858KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside
参考文献 Reference

Ⅰ．はじめに

　頚椎神経根症において，骨棘や椎間板ヘルニアによる椎間孔部での圧迫による神経根症状は，脊髄症や神経筋疾患との鑑別が困難な例もあり，正確な画像診断が必要とされる．また，外科的治療を選択するにあたり責任病巣の正確な同定が最も重要である．しかし，通常のMRI撮影法では責任病巣の同定が困難な症例も多い．

　今回われわれはtrue fast imaging with steady-state precession（true FISP），3D T2 weighted sampling perfection with application optimized contrasts using different fillip angle evolution（3D T2W SPACE），3D multi-echo data image combination（3D MEDIC）という3次元MRIを用いたcurved coronal multiplanar reconstruction（MPR）imagimgという新しい手法を用いることが頚椎神経根症の画像診断に非常に有用であると思われたため，おのおのの手法の画像特徴も含め紹介する．

　In surgical treatment of cervical radiculopathy, localization of the responsible lesions by various imaging modalities is essential. Among them, MRI is non-invasive and plays a primary role in the assessment of spinal radicular symptoms. However, demonstration of nerve root compression is sometimes difficult by the conventional methods of MRI, such as T1 weighted (T1W) and T2 weighted (T2W) sagittal or axial images. We have applied a new technique of curved coronal multiplanar reconstruction (MPR) imaging for the diagnosis of cervical radiculopathy.

　Methods: Ten patients (4 male, 6 female) with ages between 31 and 79 year-old, who had clinical diagnosis of cervical radiculopathy, were included in this study. Seven patients underwent anterior key-hole foraminotomy to decompress the nerve root with successful results. All the patients had 3D MRI studies, such as true fast imaging with steady-state precession (FISP), 3DT2W sampling perfection with application optimized contrasts using different fillip angle evolution (SPACE), and 3D multi-echo data image combination (MEDIC) imagings in addition to the routine MRI (1.5T Avanto, Siemens, Germany) with a phased array coil. The curved coronal MPR images were produced from these MRI data using a workstation.

　Results: The nerve root compression was diagnosed by curved coronal MPR images in all the patients. The compression sites were compatible with those of the operative findings in 7 patients, who underwent surgical treatment. The MEDIC imagings were the most demonstrable to visualize the nerve root, while the 3D-space imagings were the next.

　Conclusion: The curved coronal MPR imaging is useful for the diagnosis of accurate localization of the compressing lesions in patients with cervical radiculopathy.