脊髓圆锥弥散张量成像扫描在下尿路功能障碍中的应用

doi:10.3969/j.issn.1006-9771.2024.03.011

Abstract

Abstract:

Objective To investigate the signal abnormality of conus medullaris in patients with overactive bladder (OAB) and underactive bladder (UAB) by MRI diffusion tensor imaging (DTI).

Methods From May, 2021 to April, 2023, 23 patients with lower urinary tract dysfunction without trauma and supraspinal lesions were enrolled (case group). All patients underwent imaging urodynamics and pelvic floor electromyography. Based on the bladder contraction during the filling phase of urodynamics, the patients were divided into UAB group and OAB group. Eight healthy subjects were included as the control group. All participants underwent T₁₀ to L₅ spinal segment MRI scans and DTI scans. The position of conus medullaris was determined by comparing the DTI sequences with the MRI scans. The fractional anisotropy (FA), apparent diffusion coefficient (ADC), and relative anisotropy (RA) of the conus medullaris intermediate segment were compared.

Results Twelve cases were in UAB group, and eleven in OAB goup. Abnormalities were found in the pelvic floor electromyography in the case group. There was significant difference in sacral reflex arc nerve conduction testing between UAB and OAB groups (P = 0.036). Compared with the control group, ADC increased (t = 2.185, P = 0.037) in the case group; FA decreased (t = 3.439, P = 0.005) and ADC increased (t = 4.582, P < 0.001) in UAB group.

Conclusion DTI is helpful to find the potential lesion of spinal cord in patients with lower urinary tract dysfunction. FA and ADC are valuable indicators for the diagnosis of conus medullaris injury.

Key words: overactive bladder, underactive bladder, conus medullaris, diffusion tensor imaging

CLC Number:

R695

SUN Haoyu, GAO Yi, WU Juan, LIAO Limin, JING Huafang, ZHANG Siyu, LI Dong, HAN Chunsheng. Application of diffusion tensor imaging scanning of conus medullaris in lower urinary tract dysfunction[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(3): 333-338.

Figures/Tables 3

References 42

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项目	UAB组(n = 12)		OAB组(n = 11)		P值^a
项目	正常	异常	正常	异常	P值^a
皮质运动传导	4	8	5	6	0.680
阴部神经皮质感觉诱发电位	3	9	4	7	0.667
骶反射弧神经传导	2	10	7	4	0.036
阴部神经运动传导	3	9	2	9	1.000
鞍区皮肤交感反应	8	4	6	5	0.680
肛门括约肌自主收缩	6	6	4	7	0.680

项目	FA	ADC	RA
对照组	0.446±0.699	2.564±0.303	0.363±0.114
病例组	0.397±0.129	3.317±0.949	0.355±0.114
OAB组	0.447±0.147	2.743±0.823	0.370±0.138
UAB组	0.350±0.094	3.843±0.744	0.342±0.091
t值^a	1.081	2.185	0.324
P值^a	0.084	0.037	0.749
t值^b	0.008	0.567	0.128
P值^b	0.994	0.584	0.900
t值^c	3.439	4.582	0.652
P值^c	0.005	< 0.001	0.523

Application of diffusion tensor imaging scanning of conus medullaris in lower urinary tract dysfunction

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