臨床整形外科52巻12号

2017年12月発行

誌上シンポジウム 慢性腰痛のサイエンス

—最近の画像診断—拡散強調画像を用いた化膿性脊椎炎・神経根障害の診断

著者： 江口和¹ 金元洋人² 及川泰宏³ 高橋和久² 大鳥精司²

所属機関： ¹独立行政法人国立病院機構下志津病院整形外科 ²千葉大学大学院医学研究院整形外科学 ³千葉県こども病院整形外科

ページ範囲：P.1143 - P.1152

　近年，MRI装置の高磁場化やパルスシーケンスの改良に伴い，水分子の拡散を強調し画像化した拡散強調画像が発展してきた．化膿性脊椎炎において拡散強調画像はpositron emission tomography(PET)に相同性のある集積像を示し，早期鑑別に有用であった．さらに拡散テンソル画像diffusion tensor imaging(DTI)により腰部神経叢の3次元走行を鮮明に描出でき，診断困難とされる腰椎椎間孔狭窄部でtractographyの途絶を認め，拡散異方性の強さを示す指標fractional anisotropy(FA)値は低下し臨床症状と相関した．拡散強調画像により化膿性脊椎炎の早期診断や腰神経病変を可視化・定量化できる可能性があり，さらなる飛躍が期待される．

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