| 朱红军,戴 慧,张大伟,刘传道,昝云强,蔡 萍,杨卫新.颈髓损伤后骶髓DTI影像学变化与膀胱收缩指数的关系[J].中国康复医学杂志,2020,(12):1455~1459 |
| 颈髓损伤后骶髓DTI影像学变化与膀胱收缩指数的关系 点此下载全文 |
| 朱红军 戴 慧 张大伟 刘传道 昝云强 蔡 萍 杨卫新 |
| 苏州大学附属第一医院康复医学科，苏州，215000 |
| 基金项目： |
| DOI：10.3969/j.issn.1001-1242.2020.12.009 |
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| 摘要： |
| 摘要
目的：研究颈髓损伤患者骶髓神经继发性改变，探讨它与膀胱收缩功能的关系。
方法：选取20例颈髓损伤后神经源性膀胱患者作为试验对象，另选取15例正常成年人作为对照组。试验组进行尿动力检查评估膀胱收缩功能，所有对象进行骶髓弥散张量成像（diffusion tensor imaging, DTI）检查，分析S2—S4侧角和前角的DTI指标弥散各向异性（fractional anisotropy，FA）和表观弥散系数（apparent diffusion coefficient, ADC)。
结果：试验组骶髓侧角和前角的FA值分别为（0.21±0.03）和（0.22±0.03），分别较对照组显著降低（P<0.05）；试验组骶髓侧角和前角的ADC值分别为（2.44±0.53）×10-9mm2/s和（2.29±0.31）×10-9mm2/s，分别较对照组显著增加（P<0.05）。试验组骶髓侧角的FA值与膀胱收缩指数（bladder contractility index，BCI）呈正相关（r=0.758, P<0.01），骶髓侧角的ADC值与BCI呈负相关（r=-0.523, P<0.05）。试验组骶髓前角的FA值及ADC值与最大尿道压无明显相关性（P>0.05）。
结论：颈髓损伤后骶髓神经发生继发性改变，这些变化可能影响到膀胱收缩功能。 |
| 关键词：颈髓损伤 弥散张量成像 膀胱收缩指数 神经源性膀胱 |
| Relationship between sacral changes characterized by diffusion tensor imaging and bladder contractility in cervical SCI persons Download Fulltext |
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| Department of Rehabilitation Medicine, The First Affiliated Hospital of Soochow University, Suzhou，215000 |
| Fund Project: |
| Abstract: |
| Abstract
Objective：To investigate changes of sacral cord in cervical SCI persons using diffusion tensor imaging (DTI) and determine the relationship between sacral cord changes and bladder contractility.
Method： Twenty patients with complete cervical SCI and 15 control subjects, were included in the present study. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of ventral horn and intermediate column at S2-S4 level were calculated by DTI for all subjects and participants with SCI received urodynamic examination.
Result：The FA values of sacral dorsal horn and anterior horn in the experimental group were (0.21±0.03) and (0.22±0.03) and the ADC values were （2.44±0.53）×10-9mm2/s and（2.29±0.31）×10-9mm2/s. Compared with the control group, the FA values in the experimental group significantly decreased while the ADC values dramatically increased（P<0.05）. The FA value of sacral dorsal horn in the experimental group was positively correlated with bladder contractility index（BCI）（r=0.758, P<0.01） and the ADC value was negatively correlated with BCI（r=-0.523, P<0.05）. The values of FA and ADC of sacral anterior horn had no significant correlations with maximal urethral pressure in experimental group.
Conclusion: The complete cervical SCI participants showed DTI changes in sacral cord and these changes might affect bladder contraction. |
| Keywords:cervical cord injury diffusion tensor imaging bladder contractility index neurogenic bladder |
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