磁共振T_2弛豫时间和ADC评估腰椎间盘退变的对比研究  

Comparative study of MR T_2 relaxation time and apparent diffusion coefficient for assessing lumbar intervertebral disc degeneration

作　　者：黄耀渠[1] 赵晓梅[1] 伍琼慧[1] 秦红卫[1] 

机构地区：[1]广东省佛山市中医院MRI室,佛山528000

出　　处：《放射学实践》2016年第8期773-777,共5页Radiologic Practice

基　　金：广东省医学科研基金课题(A2013680);佛山市科技局医学攻关课题(201308015)

摘　　要：目的:探讨MRI定量测量T2弛豫时间和表观扩散系数(ADC)对腰椎间盘退变的诊断价值和临床意义。方法:46例无症状青年志愿者行腰椎常规MRI、T2-mapping和DWI检查。由两位医师分别对椎间盘进行Pfirrmann分级,并间隔一周2次测量髓核的T2值和ADC值。结果:同一观察者或不同观察者间测量的T2值和ADC值的一致性均较好(ICC=0.86~0.93,P<0.01)。髓核T2值及ADC值均与Pfirrmann分级呈负相关,但以T2值相关性更佳(rT2=-0.70,P<0.01;rADC=-0.60,P<0.01)。髓核T2值和ADC值在不同Pfirrmann分级之间的差异均有统计学意义(F=60.6和72.3,P<0.01);各级间两两比较,T2值的差异均有统计学意义(P<0.05)。但ADC值在PfirrmannⅠ级与Ⅱ级间的差异无统计学意义(P>0.05)。T2值和ADC值鉴别Ⅰ级与Ⅱ级、Ⅱ级与Ⅲ级、Ⅲ级与Ⅳ级椎间盘的ROC曲线下面积分别为0.86、0.92和0.80(P均<0.01);0.69(P<0.01)、0.90(P<0.01)和0.74(P<0.05)。结论:T2值和ADC值均能定量评估腰椎间盘退变,二者相互结合能更全面地观察椎间盘早期退变的特征。Objective：To study the value and clinical significance of MR quantitative measurement of T2 relaxation time and apparent diffusion coefficient （ADC） in detecting intervertebral disc degeneration. Methods： Forty-six asymptoma- tic young volunteers underwent conventional MRI, T2-mapping and diffusion weighted imaging （DWI） examination. MRI data of all subjects were evaluated by two experienced radiologists,Pfirrmann grading system was used to evaluate the de- gree of degeneration （ I - Ⅳ ） of intervertebral disc,and T2 and ADC values of nucleus pulposus were measured twice with time interval of one week. Results： The inter- and intra-observer agreement for T2 and ADC values was good to excellent （ICC was 0.86 to 0.93, P^0.01）. Significant negative correlation was observed between Pfirrmann grade and T2 value （r= --0.70, P（0.01）, as well as ADC （r --0.60, d0.01）. There was significant difference in T2 and ADC values among different Pfirrmann grades （F--60.6 and 72.3, P〈0.01）, and significant differences of T2 values were showed between each two grades （P〈0.05） ,no significant difference of ADC values was demonstrated between grade Ⅰ and Ⅱ （P）0.05）. For differentiating grade Ⅰ with Ⅱ , Ⅱ with Ⅲ , andⅢ with iV ,the area under ROC curve （AUC） of T2 value was 0.86, 0.92 and 0.80 （P〈0.01） respectively,and corresponding AUC of ADC value was 0.69 （P〈0.01） ,0.90 （P（0.01） and 0.74 （P〈0.05）. Conclusion： Both T2 and ADC are valuable quantitative parameters in assessing intervertebral disc degener- ation, and combination of them may be more comprehensive in observing the characteristics of early degeneration.

关 键 词：椎间盘退变 髓核 T2弛豫时间 扩散加权成像 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.5[医药卫生—诊断学]