Diffusion-Weighted Magnetic Resonance Imaging in Diagnostics of Spinal Nerve Root Compression in Patients with Lumbar Intervertebral Disc Herniation

The aim of the study was to evaluate possibilities of using diffusion-weighted MRI (DW MRI) in diagnostics of compression of dorsal spinal ganglia and spinal nerve roots in patients with lumbar intervertebral disc herniation (IVD).

Materials and Methods. The study involved 37 patients (19 males, 18 females, average age — 42.6±12.7) with radicular syndrome caused by an IVD hernia of the lumbosacral spine. In all the cases, the diagnosis was confirmed by a clinical-neurological examination of a patient, radiography of the lumbar spine, multi-layer spiral CT and MRI investigations (including DW MRI). The control group included 29 volunteers (16 males, 13 females, average age — 37.4±9.6), who do not have clinical neurological and neuroimaging signs of a degenerative disease of lumbar IVD.

Results. Average value of the measured diffusion coefficient (MDC) compressed by the hernia of L5 IVD root amounted to 1634.7 mm²/s, and the value of the intact — to 1109.2 mm²/s. MDC for the right-sided S1 root without compression signs was 1392.5 mm²/s, while for the left-sided one it was 1375.7 mm²/s. The average MDC value for proximal regions of the spinal roots on the hernia side was 1441.2±13.7 mm²/s, and for the roots on the intact side it was 1243.9±17.6 mm²/s (р<0.001). Average MDC values for the distal regions of the roots on the degenerated IVD side were 1446.8±173.4 and 1107.5±76.1 mm²/s, respectively (р<0.001). There is an evident direct correlation between MDC of the dorsal spinal ganglion and pain intensity according to VAS (r_s=0.089; p=0.012).

Conclusion. A specificity of compressed dorsal spinal ganglia and spinal nerve roots is their high MDC values which show microstructural changes manifested by edema, demyelination, and axonal injury. DW MRI, which enables the MDC to be calculated, is a perspective method of non-invasive instrumental diagnostics of compression nerve root syndromes in patients with degenerative IVD diseases.

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Stepanov I.А., Tetyushkin N.А., Shameeva М.А., Byvaltsev V.A. Diffusion-Weighted Magnetic Resonance Imaging in Diagnostics of Spinal Nerve Root Compression in Patients with Lumbar Intervertebral Disc Herniation. Sovremennye tehnologii v medicine 2019; 11(3): 104, https://doi.org/10.17691/stm2019.11.3.14