磁共振化学位移成像评估腰椎终板炎患者骨髓脂肪含量的研究  

Study on the Content of Fat in the Bone Marrow of Patients with Lumbar Vertebral end Plate with Magnetic Resonance Chemical Shift Imaging

作　　者：常飞霞 樊敦徽 和建伟[2] 黄刚[2] 何建宏 马小梅[2] CHANG Fei-xia;FAN Dun-hui;HE Jian-wei(Dunhuang Hospital of Gansu Province,Dunhuang 736200,Gansu Province,China)

机构地区：[1]甘肃省敦煌市医院,甘肃敦煌736200 [2]甘肃省人民医院放射科,甘肃兰州730000

出　　处：《中国CT和MRI杂志》2018年第2期114-117,共4页Chinese Journal of CT and MRI

基　　金：甘肃省青年科技基金项目(编号:17JR5RF350)

摘　　要：目的应用磁共振化学位移成像技术定量评估腰椎终板炎患者腰椎骨髓脂肪含量变化,探讨各期终板炎患者腰椎脂肪含量的差异。方法收集我院诊治并行腰椎MR检查及双能X线骨密度检查的患者,选择MR检查提示腰椎终板炎的患者48例作为研究对象,选取年龄匹配的无终板炎人群作为对照组(n=48),分别行DXA测量腰1-4椎体骨密度(BMD)值(g/cm2)及MR图像测量骨髓脂肪分数(FF)。测量骨髓脂肪含量选择经过腰椎正中的图像,手工绘制腰椎感兴趣区(ROI),避开骨皮质及病变区,每样本测量两次,测量椎体脂相、水相信号强度,并计算出FF,求其均值作为最终统计分析结果。结果终板炎患者组与正常对照组BMD值有统计学差异(P<0.001);各型终板炎组BMD值比较无统计学差异;终板炎组FF值显著高于正常对照组(P<0.001);终板炎组间比较ModicⅠ与Modic Ⅱ及ModicⅢ有统计学差异(P<0.001);ModicⅡ与ModicⅢ比较无统计学差异(P=0.54)。结论 1.MR化学位移成像作为常规MR检查基础上的无创性测定椎体骨髓脂肪含量的方法,能够比DXA骨密度测量更早发现腰椎终板炎患者松质骨强度的变化;2.ModicⅠ终板炎腰椎脂肪含量低于ModicⅡ、ModicⅢ,提示在终板炎的演变过程中,可能伴随着椎体强度的改变。Objective To evaluate the change of bone marrow fat content in patients with lumbar vertebral end plate osteochondritis and the difference of lumbar fat content in different stages of end plate osteochondritis based on magnetic resonance chemical shift imaging(MRI).Methods Collection in our hospital diagnosis and treatment of parallel 3.0T lumbar MR examination and dual energy X-ray bone density examination(DXA)of the patients.48 cases of patients with lumbar end plate osteochondritis were examined by MR.The age matched non-end-plate inflammatory group were selected as the control group(n=48).DXA measurement of bone mineral density(g/cm2)and MR image measurement of bone marrow fat fraction(FF)in lumbar 1-4,respectively.The bone marrow fat content was measured by the median of the lumbar spine,Manual drawing of the lumbar region of interest(ROI),Avoid bone cortex and lesion area,Measure two times per sample,Measurement of vertebral body fat phase,water phase signal intensity,and calculate the FF,Find the mean value as the final result of statistical analysis.Results BMD value of patients with endplate inflammation and normal control group were statistically different(P<0.001),there was no significant difference in BMD value of each type of endplate inflammation group.FF values in the group of end plates Significantly higher than the normal control group(P<0.001).There was a statistical difference between Modic I and ModicII and ModicⅢin the group of end plate inflammation(P<0.001).There was no significant difference between ModicⅡand ModicⅢ(P=0.54).Conclusion 1.MR chemical shift imaging as a noninvasive method of measuring bone marrow fat content on the basis of routine MR examination was able to compare the changes of cancellous bone strength in patients with lumbar end plate in earlier than DXA bone density measurements;2.The content of fat in the lumbar vertebral body of Modic I is lower than Modic II,Modic III,which suggests that the changes of vertebral body strength may be accompanied by the evolution

关 键 词：化学位移成像 终板炎 椎体信号强度 脂肪分数 

分 类 号：R551.3[医药卫生—血液循环系统疾病]