MRI表观弥散系数与腰椎间盘退变分级的相关性  

Correlation of the apparent diffusion coefficient of MRI with degrees of degenerated lumbar intervertebral discs

作　　者：张娅[1] 陈建宇[1] 蒋新华[2] 蔡兆熙[1] 刘珍珍[1] 

机构地区：[1]中山大学附属孙逸仙纪念医院放射科,广东广州510120 [2]中山大学附属肿瘤医院影像与微创介入中心,广东广州510060

出　　处：《中国医学影像技术》2011年第6期1264-1267,共4页Chinese Journal of Medical Imaging Technology

基　　金：广东省科技计划项目(2008B030301318)

摘　　要：目的探讨腰椎间盘髓核弥散能力与其退变程度、解剖水平的相关性。方法收集符合纳入标准的慢性下腰痛患者42例,行腰椎MRI,扫描序列为矢状位T1W、T2W及轴位T2W、DTI,椎间盘按Pfirrmann分级。测量不同退变分级及不同解剖水平各椎间盘髓核相对ADC值并进行比较,分析椎间盘退变分级、解剖水平与ADC值的相关性。结果 210个椎间盘（L1-2~L5-S1各42个）,Pfirrmann分级Ⅱ~Ⅴ级分别为73个、95个、38个、4个。所有椎间盘相对ADC值平均为0.45±0.10,Ⅱ~Ⅴ级分别为0.48±0.08、0.45±0.10、0.42±0.09、0.23±0.15;L1-2~L5-S1分别为0.44±0.08、0.45±0.08、0.45±0.10、0.45±0.11、0.45±0.12。不同退变分级椎间盘的ADC值差异有统计学意义（P〈0.01）;两两比较,除Ⅲ级与Ⅳ级两组总体无差异（P〉0.05）外,其他各级之间差异均有统计学意义（P〈0.05）。椎间盘ADC值与Pfirrmann退变分级具有相关性（r=-0.25,P〈0.05）。结论 DTI可定量评价椎间盘退变。Objective To explore the correlation of the diffusion of nucleus gelatinosus with lumbar disc anatomy and Pfirrmann＇s degeneration grades.Methods Totally 42 patients with degenerated lumbar intervertebral discs were selected and underwent MRI.Scanning sequences included sagittal T2W,sagittal T1W,transverse T1W and DTI of the lumbar spine.All discs were graded according to Pfirrmann＇s degeneration grades.The ADC value was recorded for each disc.Relative ADC values of each grade of disc and each anatomic location were compared.Results In all 210 discs,the number of GradeⅡ—Ⅴ was 73,95,38 and 4,respectively.The whole average relative ADC value was 0.45±0.10,as well as the ADC value was 0.48±0.08,0.45±0.10,0.42±0.09 and 0.23±0.15 in Grade Ⅱ—Ⅴ,respectively.The relative ADC value from L1-2 to L5-S1 was 0.44±0.08,0.45±0.08,0.45±0.10,0.45±0.11 and 0.45±0.12,respectively.Statistical differences of relative ADC values were found among degenerated discs of different grades（P〈0.01）.Significant statistics differences were found in multiple comparison（P〈0.05）,except between grade Ⅲ with grade Ⅳ（P〉0.05）.There was correlation between the ADC and Pfirrmann＇s degeneration grades（r=-0.25, P〈0.05）.Conclusion DTI can quantitively evaluate diffusion in degenerated discs.

关 键 词：腰椎 椎间盘退变 扩散磁共振成像 表观弥散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.53[医药卫生—诊断学]