磁共振DWI-ADC值在围绝经期妇女肌少症诊断的临床应用  

The clinical application of magnetic resonance DWI-ADC values in diagnosis of sarcopenia on perimenopausal women

作　　者：李树金[1] 吴晓冰 谢颖[1] 李笑琴[1] 李瑞荣 严友松 张绍伟[1] LI Shujin;WU Xiaobing;XIE Ying;LI Xiaoqin;LI Ruirong;YAN Yousong;ZHANG Shaowei(Department of Image Diagnoses,Changˊan Hospital of Dongguan City,Guangdong Province,Dongguan 523843,China;Department of Epidemic Prevention,Community Health Services Centre of Changˊan,Guangdong Province,Dongguan 523880,China)

机构地区：[1]广东省东莞市长安医院影像科,东莞523800 [2]广东省东莞市长安疾病预防控制中心,东莞523800

出　　处：《磁共振成像》2020年第5期367-369,共3页Chinese Journal of Magnetic Resonance Imaging

基　　金：东莞市社会科学发展(一般)项目基金(编号:2018507150221293)。

摘　　要：目的探讨ADC值在围绝经期妇女肌少症诊断的应用价值。材料与方法前瞻性收集2017年03月至2019年11月进行腰椎磁共振检查的20~30岁及40~60岁女性的资料,将其分为3组,即Ⅰ组20~30岁,Ⅱ组40~50岁,Ⅲ组50~60岁;采用Siemens Essenza1.5 TMR扫描仪机DWI序列采集胸12椎体上缘至腰4椎体下缘水平DWI,用自动生成的ADC图于第3腰椎水平测量椎旁肌的平均ADC值。采用SPSS 21.0统计软件进行统计分析,均数用x±s表示,腰大肌和竖脊肌的对比用配对的t检验,不同组间椎旁肌的对比用方差分析,P<0.05为差异有统计学意义。结果共纳入研究对象361例,竖脊肌和腰大肌平均ADC值分别为1.279±0.133、1.119±0.109,两组间差别有统计学意义(t=25.52,P<0.01)。Ⅰ组(105例)椎旁肌的平均ADC值1.220±0.091,Ⅱ组(143例)椎旁肌的平均ADC值1.208±0.084,Ⅲ组(113例)椎旁肌平均ADC值1.159±0.122,三组间椎旁肌平均ADC值差别有统计学意义(F=11.46,P<0.01),进一步两两比较发现,Ⅰ组和Ⅲ组、Ⅱ组和Ⅲ组组间椎旁肌平均ADC值差别均有统计学意义(P值均<0.01)。以Ⅰ组平均值减去2SD为肌少症诊断阈值,则以椎旁肌平均ADC值诊断肌少症的阈值为1.038,Ⅱ组及Ⅲ组低于1.038的共计有23例,其中22例经随访证实均为肌少症。结论通过磁共振扩散加权成像ADC值量化的方法诊断肌少症,降低了因个体差异所导致的误差,对肌少症的定性诊断具有重要价值。Objective:To evaluate the diagnostic value of Magnetic resonance DWI-ADC values in diagnosis of sarcopenia on perimenopausal women.Materials and Methods:Women aged 21-30 and 41-60 who accepted MRI in Changˊan Hospital of Dongguan City from Mar 2017 to Nov 2019 was recruited and their data were collected.According of age the included subjects were divided into three groups,namely I group of 21-30 years old,Ⅱgroup of 41-50 andⅢgroup of 51-60.DWI images from the upper margin of the thoracic 12 vertebra to the lower margin of the lumbar 4 vertebra were captured with DWI sequences at Siemens Essenza 1.5 T system.The average ADC values of paravertebral muscles at the level of the lumbar 3 vertebra on the automatically generated ADC maps were measured.SPSS 21.0 was used to perform all analyses.The means of average ADC values were described as(x±s).Paired-sample t test was used to compare difference between the means of average ADC values of psoas and erector spinae.Single factor analysis of variance(ANOVA)was used to compare differences on the means of average ADC values of paravertebral muscles among three groups.The difference was statistically significant with P<0.05.Results:Three hundred and sixty-one subjects were included.The means of average ADC values of psoas and erector spinae were respectively 1.279±0.133 and 1.119±0.109,and there was a significant difference between the two groups(t=25.52,P=0.000).The means of average ADC values of paravertebral muscles from I group(n=105),Ⅱgroup(n=143)andⅢgroup(n=113)were respectively 1.220±0.091,1.208±0.084 and 1.159±0.122,and there were significant differences among the three groups(F=11.46,P=0.000).Through further pairwise comparison significant differences were found between I group andⅡgroup(P<0.01),Ⅱgroup andⅢgroup(P<0.01).Based on 1.038(x-2 SD)of average ADC values of paravertebral muscles from I group as diagnostic thresholds of sarcopenia,a total of 23 fromⅡgroup andⅢgroup were below 1.038.Twenty-two cases among them were confirmed sarcopen

关 键 词：肌少症 围绝经期 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R685.5[医药卫生—诊断学]