The Application Of PROSET Sequence In The Imaging Of Lumboscacral Nerve Root

IntroductionLow back pain is a popular disease. The common pathogeny is lumbar disc hemiation, the mechanical compression and chemical stimulability of the lumbar nerve root in its channel is the primary mechanism inducing low back pain. Animal experimental model shows; mild compression in the lumbar nerve channel firstly makes the ganglion transmutation, the increasing compression makes the nerve root and ganglion transmutation. Lumboscacral nerve root anomalies ( LSNRA) is bringing the clinical attention highly as an important impressionable ingredient This is related to the special anatomical configuration and position nearly. At present, all the imaging methods are not enough to display the extradural spinal nerve and ganglion clearly. It depresses the accuracy and objectivity of the radiodiagnosis. PROSET is a binomial technique, which gives good results in inflow angiography and abdominal scan. But there is no special reports about the application of PROSET sequence in the imaging of the lumboscacral nerve root My study will discuss the application of PROSET sequence used in lumboscacral nerve root imaging by the comparison of PROSET sequence and MRINMRM in the normal and cases group respectively.Material and Method30 normal volunteers was studied, 14 males, 16 females, with their ages averaged 33.7 years old ranging from 21 to 51 years old. Ill outpatients of low back pain in shaoxing hua yu hospital affiliated to China Medical University. 54 males, 57 females, with their ages averaged 43.1 years old ranging from 17 to80 years old,had different disease courses varying from one day to 13 years . We performed MR scanning for all of them after excluding the contraindications of MR scanning.The Philips New intera magnetic resonance machine was applied for lumbar vertebral scan. The participators were supine , firstly lumbar routine scanning ; sagittal TSE sequence T1W,T2W and traverse TSE sequence T2W(including L3 - 4, L4 - 5, L5 -S1 disc); after that, coronary 3D FSE sequence MRM and 3D FFE sequence PROSET scanning.We evaluated the vision of every nerve root segment performed by PROSET and MRM respectively; measured the related values of L1 - S1 nerve roots in normal group . included the length of ganglion and the pro - ganglion nerve root, the width of ganglion , the diameter of the pro - ganglion nerve root , the angle between nerve root and the dural sac, the area of the ganglion. Then measured the ganglion areas in cases group; observe the configuration changes of the ganglions in lumbar disc herniation patients; discussed the PROSET representation of the low back pain patients.The comparison about the nerve root vision of normal group used by PRO-SET and MRM sequence was analyzed by paired chi square Test; Measurement datas of the ganglions were analyzed by independent - sample T test between the medial disc herniation cases and normal cases ,the uninvolved ganglions of the paramedial disc herniation cases . Paired - sample T test was used between left and right ganglions of the normal cases and the paramedial disc hemiation cases.ResultsPROSET images could display the pro - ganglion nerve root sheath of L1 -S1 excellently, The display rate is above 94. 64% , and the vision of L1 - S1 nerve root sheath is not different(P >0, 05 ) ; the vision of the post - ganglion nerve sheath of L1 -L5 nerve root is different,The display rate of L3 -S1 is a-bove the L1 - L2 ,the rate is 96.43% and 76.79% respectively, the vision of the nerve fibre in L1 - S1 nerve root is different, and is related to the segment ofnerve root; the nerve fibre in nerve root of L3 - SI could be displayed better. The display rate is above 87. 50%.PROSET images could measure the related parameters of lumboscacral nerve root All the measured values increase from L1 to S1, except for the angle between nerve root and the dural sac. But the the length of the pro - ganglion nerve root of S1 is 95.52% of the L5's.There is no difference between two ganglions of the median hemiation cases ( P > 0.05 ). In the mediolateral hemiation cases, the involved ganglions are bigger than the uninvolved ganglions(P <0. 05). the uninvolved ganglions and the ganglions of the median hemiation cases are bigger than the normal cases' But there is no differnce between them(P >0.05).The PROSET's detection rate of nerve root anomalies was 13. 33% ,higher than that of MRI and MRM, their detection rate is 7. 62% and 1. 90% respectively. There is visible difference among them( x~2 = 8.59,P=0.014<0. 05). There is no difference between PROSET sequence and MRI + MRM for the diagnosis of nerve root compression caused by lumbar disc hemiation. But PROSET image can display the excluding nucleus material directly.DiscussionPROSET is a binomial technique that suppresses the fat inside and about the vertebral body. The use of PROSET does not increase scan time. The image can be improved by the Volume shim technique, we studied the images of PRO-SET compared with the MRM sequence and concluded that PROSET images can display all parts of L1 - S1 nerve root out of the dural sac, and is related to the segment of nerve root;This is related to the shape of nerve root,vascular plexus of vertebral canal and the pathway of the post - ganglion nerve root PROSET images can measure related parameters of lumboscacral nerve root. Compared with the measured values used the specimen made of the dead body, PROSET assures that all the values are obtained in the normal physiological functions bodies, avoiding the influence of physical and pharmacological factors. We concluded that There is no difference between two ganglions of the median hernia-...