椎间盘退变的磁共振弥散加权成像研究  

Research on magnetic resonance diffusion weighted imaging for intervertebral disc degeneration

作　　者：俎金燕[1] 王晨光[1] 贾宁阳[2] 刘洪超[1] 张沉石[1] 徐雪元[1] 

机构地区：[1]第二军医大学附属长征医院影像诊断科,上海200003 [2]第二军医大学附属东方肝胆医院影像诊断科

出　　处：《脊柱外科杂志》2012年第6期356-359,共4页Journal of Spinal Surgery

基　　金：上海市科学技术委员会生物医药课题(09411953300);上海市卫生局课题(2010060)

摘　　要：目的运用磁共振弥散加权成像技术定量分析椎间盘退变,以期对椎间盘早期退变进行定量诊断。方法88例对象430个椎间盘纳入研究(排除磁敏感性伪影较重的10个椎间盘),行PM分级后经GE 1.5T超导MRI对腰椎行常规(矢状面T1加权、T2加权和横断面T2加权)和矢状面弥散加权成像(diffusion weighted imaging,DWI)。其中脊柱常规扫描采用快速自旋回波(fast spin echo,FSE)脉冲序列,弥散成像采用平面回波成像(echo-planar imaging,EPI)脉冲序列。根据正中矢状面T2加权像椎间盘形态及信号变化,在ADW4.2后处理工作站使用Function tool图像处理软件对图像进行后处理,在DWI矢状面上分别对腰椎椎间盘手动画出感兴趣区并测量其信号强度与表观弥散系数(apparent diffusion coefficient,ADC)值。结果 430个椎间盘纳入DWI研究,PM分级Ⅰ级0个,Ⅱ级166个;Ⅲ级146个;Ⅳ级69个;Ⅴ级49个。经Kruskal-Wallis秩和检验,ADC值与PM分级有相关性(P<0.05)。以ADC=1.05×10-3mm2/s作为评价椎间盘状态定量指标,其灵敏度为73.48%,特异度为75.30%。结论磁共振弥散加权成像可定量评价椎间盘退变程度。Objective To use magnetic resonance diffusion weighted imaging for quantitative analysis of intervertebral disc degeneration, so as to make early quantitative diagnosis . Methods Totally 430 intervertebral discs（excluding the suscepti- bility artifacts） of 88 cases underwent lumbar MRI examination. With GE 1.5T MRI, the 430 intervertebral discs were exam- ined on routine （lumbar sagittal T1WI, T2WI and T2WI cross section ） and diffusion weighted imaging （DWI） sagittal scan. Routine scanning adopted fast spin echo （FSE） pulse train. DWI adopted echo-planar imaging （EPI）pulse train. According to the median sagittal plane T2WI disc morphology and signal changes, the intervertebral discs fell into 5 grades on PM grading standard. In ADW 4.2 processing workstation, the function tool image processing software was used for image processing. The region of interest and the signal strength and apparent diffusion coefficient（ADC） value in the sagittal plane of DWI on lumbar intervertebral discs were drawn. Results Totally 430 discs were included in this DWI research, including PM grade Ⅰ 0,Ⅱ 166;Ⅲ 146; Ⅳ 69; and Ⅴ49. Kruskal-Wallis test showed that there was correlation between ADC and PM grading （P 〈 0.05）. With ADC = 1.05 ×10-3 mm2/s as the quantitative indicator for evaluation of disc state, the sensitivity of the pres- ent method was 73.48% and the specificity was 75.30%. Conclusion DWI is a non-invasive way for quantitative evalua- tion of the degeneration of intervertebral discs.

关 键 词：腰椎 椎间盘 磁共振成像 弥散 

分 类 号：R814.46[医药卫生—影像医学与核医学]