腰椎间盘退行性变的磁共振弥散加权成像研究  

MR diffusion weighted imaging study of the degeneration of lumbar intervertebral disc

作　　者：俎金燕[1] 王晨光[1] 贾宁阳[2] 何倩[3] 陶晓峰[4] 

机构地区：[1]第二军医大学附属长征医院影像科,上海200003 [2]第二军医大学附属第三医院放射科 [3]第二军医大学统计教研室 [4]同济大学附属东方医院

出　　处：《实用放射学杂志》2013年第4期611-614,634,共5页Journal of Practical Radiology

基　　金：基金项目：上海市科委重点课题（09411953300）;上海市卫生局课题（2010060）.

摘　　要：目的探讨磁共振弥散加权成像（diffusion weighted imaging，DWI）无创、定量的方法评价活体椎间盘退变程度的价值。方法分别对408个椎间盘行DWI横断面扫描，测量其表观弥散系数（apparent diffusion coefficients，ADC）并获得伪彩图。根据Pfirrmann（Pm）分级，对不同级别椎间盘进行定量分析比较。结果①Pm分级越高，其ADC越低，且具有统计学差异。②20岁以前，ADC值随年龄增长而增高；20岁以后，年龄越大，ADC值越低；③不同椎间盘节段之间ADC值差异显著。④以ADC界值=l_04×10。mm2／s为界值，其评价椎间盘状态的灵敏度76．11％，特异度80．13％。结论DWI可作为定量评价椎间盘退变程度的方法，ADC值可用来评价椎间盘退变程度。Abstract：Objective To explore the value of diffusion weighted imaging（DWI） as a non-invasive, quantitative method to evalu- ate the degree of disc degeneration in vivo. Methods MR DWI were performed in 408 intervertebral discs. The apparent coefficient diffusion （ADC} values of discs were measured and pseudocolor images were obtained. According to Pifirrman（Pm） classification for degenerative disc, the ADC values of dics were analysed quantitatively. Results OADC values of degenerated intervertebral discs were correlated with Pfirrmann grades：the higher were the Pro, the lower were the ADC, there were significant differences （P~ 0.05}. （~）The age was correlated with Pfirrmann grades of degenerated intervertebral discs：before 20, the younger, the higher were the ADC values; after 20, the older, the lower were the ADC values. ③ADC values in different segment of the degenerated interver- tebral discs were of significantly differences. ④The specificity and sensitivity in evaluation of degenerated disc with ACD were 80.13% and 76.11%, respectively, when the threshold was 1.04 X 10 3 mm2/s. Conclusion DWI is a non-invasive method in as sessment of intervertebral disc degeneration in vivo,ADC values can contribute to the evaluation of intervertebral disc degeneration.

关 键 词：脊椎 腰椎间盘退变 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R681.53[医药卫生—外科学]