磁共振扩散加权成像定量评价腰椎间盘退变的Meta分析  

A Meta analysis of quantitative evaluation of lumbar disc degeneration by diffusion weighted magnetic resonance imaging

作　　者：马红菊 张旭胤 POKHAREL SAUGAT 郭银霞[1] 杜永浩[1] 王蓉[1] 牛刚[1] MA Hongju;ZHANG Xuyin;POKHAREL SAUGAT;GUO Yinxia;DU Yonghao;WANG Rong;NIU Gang(Department of Medical Imaging,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Imaging,Xixiang County People’s Hospital of Shaanxi Province,Hanzhong 723500,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,西安710061 [2]陕西省西乡县人民医院影像科,汉中723500

出　　处：《磁共振成像》2020年第12期1138-1142,1155,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：陕西省重点研发计划一般项目(编号:2020SF-104)。

摘　　要：目的基于Meta分析探讨磁共振扩散加权成像在定量评价早期腰椎间盘退变中的临床应用。材料与方法检索自建库至2019年10月1日在PubMed、EMBASE、the CochraneLibrary、中国知网、万方、维普数据库中发表的运用扩散加权成像评价腰椎间盘退变的相关文献。2名研究者独立按照纳入和排除标椎对检索到的文献进行筛选和数据提取。使用Combie横断面研究评价工具对纳入文献进行质量评价。采用RevMan5.3和Stata15.0软件进行Meta分析。结果纳入文献12篇。Ⅰ级椎间盘共577个,Ⅱ级椎间盘共1704个,Ⅲ级椎间盘共1299个,Ⅳ级椎间盘共1092个,Ⅴ级椎间盘共194个。Ⅰ级椎间盘髓核ADC值高于Ⅱ级椎间盘髓核ADC值,差异有统计学意义[加权均数差(weighted mean difference,WMD)=0.034,95%CI:0.005~0.064,P=0.024];Ⅱ级椎间盘髓核ADC值显著高于Ⅲ级椎间盘髓核ADC值(WMD=0.161,95%CI:0.124~0.197,P<0.0001);Ⅲ级椎间盘髓核ADC值显著高于Ⅳ级椎间盘髓核ADC值(WMD=0.297,95%CI:0.222~0.373,P<0.0001);Ⅳ级椎间盘髓核ADC值显著高于Ⅴ级椎间盘髓核ADC值(WMD=0.293,95%CI:0.176~0.411,P<0.0001)。结论扩散加权成像可以定量评价不同等级的腰椎间盘退变,尤其可以区分早期腰椎间盘退变,为早期诊断腰椎间盘退变提供影像学依据。Objective:Based on Meta analysis to explore the clinical application of magnetic resonance diffusion weighted imaging in quantitative evaluation of early lumbar disc degeneration.Materials and Methods:Literature on evaluation of lumbar disc degeneration using diffusion weighted imaging(DWI)published in PubMed,EMBASE,the Cochrane Library,CNKI,Wanfang and VIPS databases from the self-built database to October 1,2019 was retrieved.Two researchers independently screened and extracted the retrieved literature according to inclusion and exclusion criteria.Combie cross study evaluation tool was used to evaluate the quality of the included literature.Using RevMan 5.3 and Stata 15.0 software for Meta analysis.Results:A total of 12 references were included.There were 577 gradeⅠdiscs,1704 gradeⅡdiscs,1299 gradeⅢdiscs,1092 gradeⅣdiscs and 194 gradeⅤdiscs.ADC value of gradeⅠdiscs nucleus pulposus was higher than that of gradeⅡdiscs nucleus pulposus.The difference was statistically significant weighted mean difference(WMD)=0.034,95%CI:0.005—0.064,P=0.024.ADC value of gradeⅡdiscs nucleus pulposus was significantly higher than that of gradeⅢdiscs nucleus pulposus(WMD=0.161,95%CI:0.124—0.197,P<0.0001).ADC value of gradeⅢdiscs nucleus pulposus was significantly higher than that of gradeⅣdiscs nucleus pulposus(WMD=0.297,95%CI:0.222—0.373,P<0.0001).ADC value of gradeⅣdiscs nucleus pulposus was significantly higher than that of gradeⅤdiscs nucleus pulposus(WMD=0.293,95%CI:0.176—0.411,P<0.0001).Conclusions:Diffusional weighted imaging can quantitatively evaluate different grades of lumbar disc degeneration,especially distinguish early lumbar disc degeneration,and provide imaging basis for early diagnosis of lumbar disc degeneration.

关 键 词：扩散加权成像 磁共振成像 表观扩散系数 腰椎间盘退变 META分析 

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]