3.0T磁共振成像T2 mapping联合纹理分析评估腰椎小关节退变程度  

Combination of 3.0T magnetic resonance imaging T2 mapping with texture analysis for evaluating the degeneration of lumbar facet joints

作　　者：罗慕晴 冯智超[1] 廖云杰[1] 钟东 李万猛[1] 梁琪[1] LUO Muqing;FENG Zhichao;LIAO Yunjie;ZHONG Dong;LIWanmeng;LIANG Qi(Department of Radiology,Third Xiangya Hospital,Central South University,Changsha 410013;Department of Spine Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅三医院放射科,长沙410013 [2]中南大学湘雅医院脊柱外科,长沙410008

出　　处：《中南大学学报（医学版）》2020年第7期827-833,共7页Journal of Central South University ：Medical Science

基　　金：湖南省重点研发计划项目(2015SK20664)。

摘　　要：目的:定量磁共振技术已成功应用于评估软骨生化成分状态,本研究旨在探讨磁共振成像T2 mapping联合纹理分析在评估腰椎小关节退变程度中的应用价值。方法:对38例腰部受检者(无症状组20例与症状组18例)行3.0T磁共振腰椎常规序列、三维快速扰相梯度回波水激励序列(water excitation three-dimensional spoiled gradient echo sequence,3D-WATSc)及T2 mapping扫描。采用Weishaupt标准对L4/5~L5/S1双侧小关节进行形态学分级,并测量小关节软骨T2值及T2 mapping图像纹理特征值。采用Kruskal-Wallis H检验比较不同退变程度组各参数值的差异,利用多变量logistic回归分析获得预测腰椎小关节早期退变的独立因素,应用受试者工作特征(receiver operating characteristic,ROC)曲线分析各参数区分效能并计算曲线下面积(area under the curve,AUC)。采用Spearman相关分析评价软骨T2值及纹理参数中的独立预测因素与受试者日本骨科协会(Japanese Orthopedic Association,JOA)评分、疼痛视觉模拟量表(Visual Analogue Scale,VAS)评分的相关性。结果:共纳入148个小关节,包括0级(正常)70个、1级(退变早期)58个及2~3级(退变中晚期)20个。T2值、熵、对比随小关节退变程度的加重而增加(P<0.05),逆差距、能量及相关则随之降低(P<0.05)。熵在各级间两两比较差异均有统计学意义(均P<0.05),T2值、对比、逆差距和能量在正常与退变早期、正常与退变中晚期小关节之间差异有统计学意义(均P<0.05)。Logistic回归分析显示,T2值和逆差距是预测腰椎小关节早期退变的独立因素,两者联合区分正常与退变早期小关节的效能最佳(AUC=0.85),灵敏度和特异度分别为92.7%和76.5%。在症状组中,受试者软骨T2值联合逆差距与其JOA评分(r=0.475,P<0.05)及VAS评分(r=0.452,P<0.05)均呈正相关。结论:3.0T T2 mapping联合纹理分析有助于定量评估腰椎小关节早期退变,其中T2值及逆差距有较高的参考Objective:Quantitative magnetic resonance imaging has been successfully applied to assess the status of cartilage biochemical components.This study aimed to investigate the performance of 3.0 T magnetic resonance imaging T2 mapping combined with texture analysis for evaluating the early degeneration of lumbar facet joints.Methods:A total of 38 patients(20 in the asymptomatic group and 18 in the symptomatic group)were enrolled.All patients underwent 3.0 T magnetic resonance imaging conventional sequences,water excitation three-dimensional spoiled gradient echo sequence(3 D-WATSc),and T2 mapping scans.The bilateral L4/5 and L5/S1 lumbar facet joints were morphological graded using the Weishaupt criteria,T2 values,and texture parameters derived from T2 mapping of cartilage.The Kruskal-Wallis H test was used to compare the differences of parameters among different groups.Multivariate logistic regression analysis was used to obtain the independent predictive factors for evaluating the early degeneration of lumbar facet joints.Receiver operating characteristic(ROC)curve was performed and the area under curve(AUC)was calculated.Spearman correlation analysis was used to evaluate the correlation of the independent predictors of cartilage T2 value and texture parameters with the subjects’Japanese Orthopedic Association(JOA)score or Visual Analogue Scale(VAS)score.Results:A total of 148 facet joints were selected,including 70 in Weishaupt 0(normal)group,58 in Weishaupt 1 group,and 20 in Weishaupt 2-3 group.T2 value,entropy,and contrast increased significantly as the exacerbation of facet joint degeneration(all P<0.05),while the inverse difference moment,energy,and correlation decreased(all P<0.05).Entropy among different groups was significantly different(all P<0.05),and the differences of T2 value,contrast,inverse difference moment,and energy between Weishaupt 0 and Weishaupt 1 groups,or Weishaupt 0 and Weishaupt 2-3 groups were statistically significant(all P<0.05).Multivariate logistic regression analysis suggested tha

关 键 词：腰椎小关节 磁共振成像 纹理分析 早期退变 

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]