无症状成人腰椎间盘退变磁化传递率与椎间盘退变分级的相关性研究  

Correlation between Magnetization Transfer ratio of Lumbar Intervertebral Disc Degeneration and the Grade of Disc Degeneration in Asymptomatic Adults

作　　者：郭安娜 严志汉[1] 李清萍 章智敬[1] 陈少卿 黄荧荧 叶佩佩 何家维[1] Guo Anna;Yan Zhihan;Li Qingping(Department of Radiology,the Second ffiliated Hospital of Wenzhou Medical U-niversity,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院放射科,325027 [2]湖北省十堰市人民医院放射科,442000

出　　处：《医学研究杂志》2020年第11期132-136,共5页Journal of Medical Research

基　　金：浙江省温州市科学技术协会创新项目(2019KXCX-KT);浙江省温州市科技局医疗卫生项目(Y20190670)。

摘　　要：目的探讨无症状成人腰椎间盘髓核的磁化传递率(magnetization transfer ratio,MTR)与椎间盘退变分级的相关性。方法对290例无症状志愿者进行腰椎间盘MRI矢状位常规序列及SPGR磁化传递(magnetization transfer,MT)脉冲序列扫描,通过Pfirrmann分级评价椎间盘退变情况,测量不同Pfirrmann分级、椎间盘节段及各年龄分组的髓核MTR值。分析髓核MTR值与Pfirrmann分级、年龄、BMI、椎间盘节段的相关性及髓核MTR值的性别差异。结果髓核MTR值与Pfirrmann分级呈中度正相关(r=0.503,P=0.000);生理性退变的椎间盘(PfirrmannⅠ~Ⅱ级)和退变椎间盘(PfirrmannⅢ~Ⅴ级)的髓核MTR值比较,差异有统计学意义(P=0.000),ROC曲线的曲线下面积(AUC)为0.820,髓核MTR的界值为26.75%,其评价退变椎间盘的敏感度为0.786,特异性为0.724。腰椎间盘髓核MTR值具有性别差异(P=0.000),男性、女性的髓核MTR值均与年龄呈正相关(r=0.366,P=0.000;r=0.416,P=0.000)。髓核MTR值与BMI、椎间盘节段之间均呈正相关(r=0.206,P=0.000;r=0.233,P=0.000),下位腰椎间盘节段(L4/5、L5/S1)的髓核MTR值高于上位椎间盘节段(L1/2、L2/3)(P=0.000)。结论腰椎间盘髓核的MTR值随着腰椎间盘退变加重而增加,下位腰椎间盘的髓核MTR值高于上位腰椎间盘。腰椎间盘髓核的MTR值随着年龄增长、BMI升高而增加,并且存在性别差异。Objective To investigate the correlation between the magnetization transfer ratio(MTR)of lumbar disc nucleus pulposus and the grade of intervertebral disc degeneration in asymptomatic adults.MethodsA total of 290 asymptomatic volunteers underwent lumbar disc MRI sagittal routine sequence and SPGR magnetization transfer(MT)pulse sequence scan.Intervertebral disc degeneration was evaluated by the Pfirrmann grading standard.The MTR values of nucleus pulposus of different Pfirrmann grades,intervertebral disc segments,and age groups were measured.The correlation between MTR value of nucleus pulposus and Pfirrmann grading,age,BMI and intervertebral disc segment was analyzed,so was the the gender difference of MTR value of nucleus pulposus.ResultsThe MTR value of nucleus pulposus was positively correlated with Pfirrmann grading(r=0.503,P=0.000).There was a statistical difference in the MTR value of the nucleus pulposus between the physiologically degenerated intervertebral disc(PfirrmannⅠ-Ⅱgrade)and the degenerated intervertebral disc(PfirrmannⅢ-Ⅴgrade)(P=0.000).The AUC of the ROC curve was 0.820.The cut-off value of the MTR of nucleus pulposus was 26.75%.The sensitivity to evaluate disc degeneration was 0.786,and the specificity was 0.724.The MTR value of lumbar disc nucleus pulposus had a gender difference(P=0.000).The MTR value of the nucleus pulposus of both men and women was positively correlated with age(r=0.366,P=0.000;r=0.416,P=0.000).There was a positive correlation between the MTR value of nucleus pulposus and BMI and intervertebral disc segment(r=0.206,P=0.000;r=0.233,P=0.000).The MTR values of nucleus pulposus of the lower lumbar disc segments(L4/5,L5/S1)were higher than those of the upper disc segments(L1/2,L2/3)(P=0.000).ConclusionThe MTR value of the Lumbar disc nucleus pulposus increases with intervertebral disc degeneration.The MTR values of the nucleus pulposus of the lower lumbar discs were higher than those of the upper lumbar discs.The MTR value of the lumbar disc nucleus pulposus increases

关 键 词：腰椎间盘 退变分级 磁化传递率 磁共振 

分 类 号：R445.3[医药卫生—影像医学与核医学] R681.5[医药卫生—诊断学]