腰椎骨质疏松性骨折患者椎旁肌肉MRI指标测量及临床意义  

Measurement of paravertebral muscle indicators on MRI in the patients with osteoporotic vertebral fracture and its clinical significance

作　　者：刘斌[1] 刘向阳[1] 王国平[1] 沈雄杰[1] 常磊[1] 彭帅[1] 张明彦 Liu Bin;Liu Xiangyang;Wang Guoping;Shen Xiongjie;Chang Lei;Peng Shuai;Zhang Mingyan(Department of Spinal Surgery,Hunan Provincial People’s Hospital(the First Affiliated Hospital of Hunan Normal University),Changsha 410005,Hunan Province,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)脊柱外科,湖南省长沙市410005

出　　处：《中国组织工程研究》2019年第4期578-583,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:椎体骨质疏松性骨折的病因是是多因素的综合,目前认为骨量减少、跌倒、既往骨折史是其主要的危险因素,但具体的发病机制还有待进一步研究。目的:测量分析腰椎椎体骨质疏松性骨折患者椎旁肌肉的MRI影像学指标,探讨其与椎体骨折发生的相关性。方法:选取湖南省人民医院2014年6月至2017年12月收治的临床资料完整的95例腰椎椎体骨质疏松性骨折患者为研究对象,行腰椎MRI平扫检查评估患者腰椎椎旁肌肉面积及脂肪变性程度,测量指标包括双侧椎旁肌(多裂肌和竖脊肌)的横截面积、椎体横截面积、腰椎肌肉程度及脂肪变性比例。根据骨折椎体数量,将骨折组分为单发骨折组和多发骨折组,并选取同时期32例无椎体骨折的骨质疏松症患者为对照组,采用独立样本t检验,比较3组患者椎旁肌肉MRI指标的差异。结果与结论:(1)单发骨折组和多发骨折组多裂肌和竖脊肌的横截面积均较对照组明显减少,差异有显著性意义(P <0.05),而2个骨折组之间差异无显著性意义(P> 0.05);(2)对照组、单发骨折组和多发骨折组的椎体横截面积比较,组间两两比较差异均无显著性意义(P> 0.05);(3)与无骨折的对照组相比,单发骨折组和多发骨折组的腰椎肌肉程度均明显减少(P <0.05),但2个骨折组之间差异无显著性意义(P> 0.05);(4)多发骨折组的脂肪变性比例明显高于对照组(P <0.05),余组间比较差异无显著性意义(P> 0.05);(5)提示腰椎骨质疏松性骨折患者的椎旁肌肉数量及质量均较无椎体骨折的骨质疏松症患者下降,提示腰椎椎旁肌肉退变可能是椎体骨质疏松性骨折的潜在致病因素。BACKGROUND:Etiology of osteoporotic vertebral fracture is a combination of multiple factors.Bone loss,falls and previous fracture history are considered to be the main risk factors,but the specific pathogenesis remains to be further studied.OBJECTIVE:To measure the indicators of paravertebral muscles on MRI in patients with osteoporotic vertebral fracture and to investigate its correlation with the occurrence of vertebral fracture.METHODS:Ninety-five patients with osteoporotic vertebral fracture patients and with complete clinical data admitted in Hunan Provincial People’s Hospital from June 2014 to December 2017 were enrolled.The cross sectional area of paravertebral muscles and the fatty degeneration ratio were examined and assessed through MRI.The measurement parameters were as follows:the cross sectional area of bilateral multifidi and erector spinae,the cross sectional area of vertebral body,the degree of lumbar vertebrae muscles,and the fatty degeneration ratio.The fracture group was divided into single fracture and multiple fracture groups according to the number of fractured vertebrae.Meanwhile,32 osteoporosis patients without fracture were enrolled as control group.Independent sample t test was used to compare the differences in the MRI indicators of the paravertebral muscles in the three groups.RESULTS AND CONCLUSION:(1)Compared with the control group,the cross sectional areas of bilateral multifidi and erector spinae in the single fracture and multiple fracture groups were decreased significantly(P<0.05).There was no significant difference between two fracture groups(P>0.05).(2)There was no significant difference in the cross sectional area of vertebral body between two groups(P>0.05).(3)Compared with the control group,the degree of lumbar vertebrae muscles in the single fracture and multiple fracture groups was significantly reduced(P<0.05).However,there was no significant difference between two fracture groups(P>0.05).(4)The fatty degeneration ratio in the multiple fracture group was significantly

关 键 词：腰椎 骨质疏松性骨折 磁共振成像 组织工程 椎体骨质疏松性骨折 椎旁肌肉面积 腰椎骨折 椎旁肌肉磁共振测量 腰椎椎旁肌肉退变 

分 类 号：R445[医药卫生—影像医学与核医学]