体素内不相干运动扩散加权成像定量评价腰椎间盘退行性变的初步研究  

A preliminary study of quantitative evaluation on lumbar intervertebral disc degeneration with intravoxel incoherent motion diffusion weighted imaging

作　　者：邓兴 姚红艳 陈晓飞[2] 祁艳梅 汪新柱[2] 董馥闻 贾润慧[2] 周晟[2] DENG Xing;YAO Hongyan;CHEN Xiaofei;QI Yanmei;WANG Xinzhu;DONG Fuwen;JIA Runhui;ZHOU Sheng(Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China;Department of Medical Imaging,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China;Departmentof Interventional Radiology,Nanchong Central Hospital,Nanchong,Sishuan Province 637000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省中医院放射影像科,甘肃兰州730050 [3]南充市中心医院介入放射科,四川南充637000

出　　处：《实用放射学杂志》2021年第7期1156-1160,共5页Journal of Practical Radiology

基　　金：甘肃省卫生行业科研计划项目(GSWSKY2018-27);甘肃省自然科学基金项目(17JR5RAO53).

摘　　要：目的 探讨体素内不相干运动扩散加权成像(IVIM-DWI)参数与腰椎间盘退行性变(IVDD)之间的相关性.方法 纳入30例无症状成年人及30例下腰痛(LBP)患者在3.0T MRI行腰椎扫描.采用IVIM-DWI测量前纤维环(AAF)、髓核(NP)、后纤维环(PAF)的标准表观扩散系数(ADC_(standard))、快速表观扩散系数(ADC_(fast))、慢速表观扩散系数(ADC_(slow))和灌注分数(f),10个b值(0、10、20、40、60、80、100、200、400、600 s/mm^(2))用于IVIM采集.方差齐性资料采用单因素方差分析,方差不齐时采用非参数检验比较不同Pfirrmann分级、不同节段椎间盘的IVIM参数值.椎间盘Pfirrmann分级与椎间盘IVIM各参数的相关性采用Spearman相关分析.结果 单因素方差分析显示,除AAF的ADC_(standard)、ADC_(fast)、f值及PAF的f值在不同节段间的差异无统计学意义外(P>0.05),其余不同节段间的IVIM参数差异均有统计学意义(P<0.05).Spearman相关分析显示,Pfirrmann分级与椎间盘AAF、NP、PAF的ADC_(standard)、ADC_(slow)值及NP的ADCfast值均呈负相关(r=-0.497,-0.622,-0.517,-0.402,-0.578,-0.435,-0.155;P<0.05),与NP的f值呈正相关(r=0.237;P<0.01),与椎间盘AAF、PAF的ADC_(fast)值、f值无明显相关(P>0.05).结论 IVIM-DWI技术可以应用于IVDD的定量研究,ADC_(standard)、ADC_(slow)、ADC_(fast)、f值可定量评估椎间盘的扩散及灌注情况,有助于诊断早期IVDD.Objective To investigate the correlation between the intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)parameters with lumbar intervertebral disc degeneration(IVDD).Methods A total of 30 asymptomatic adults and 30 patients with low back pain(LBP)were included in this study with lumbar spine scan at 3.0T MRI.IVIM-DWI was used to measure the standard apparent diffusion coefficient(ADC_(standard)),fast apparent diffusion coefficient(ADC_(fast)),slow apparent diffusion coefficient(AD_(Cslow)),and perfusion fraction(f)of the anterior annulus fibrosus(AAF),nucleus pulposus(NP)and posterior annulus fibrosus(PAF),and 10 b values(0,10,20,40,60,80,100,200,400,600 s/mm^(2))were used for IVIM acquisition.3;ANOVA was used to compare different Pfirrmann grading and IVIM parameters with homogeneous variance data,and nonparametric test was used in case of uneven variance.Spearman correlation analysis was used to analyze the correlation between Pfirrmann grading and IVIM parameters of intervertebral disc.Results One-way ANOVA analysis showed that the difference in ADC_(slandard),ADC_(fast) and f value of AAF,f value of PAF among different segments had no significantly correlated(P>0.05),the differences in IVIM parameters among the remaining different segments were significantly correlated(P<C 0.05).Spearman correlation analysis showed that the Pfirrmann grading was negatively correlated with the ADC_(standard),ADC_(slow) value of AAP,NP,PAF and ADC_(fast) value of NP(r=-0.497,-0.622,-0.517,-0.402,-0.578,-0.435,_0.155;P<C0.05),which was positively correlated with the f value of NP(r=0.237;P<C0.01),and had no significant correlation with the ADC_(fast) value and f value of AAF and PAF(P>0.05).Conclusion The IVIM-DWI technique can be applied to quantitatively study the IVDD,the values of ADCstandard,ADC_(slow),ADC_(fast) and f can be used to quantitatively evaluate the dispersion and perfusion of intervertebral disc,which is helpful for the diagnosis of early IVDD.

关 键 词：体素内不相干运动 扩散加权成像 椎间盘退行性变 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.53[医药卫生—诊断学]