IDEAL序列定量评估早期强直性脊柱炎椎旁肌脂肪浸润  

Quantitative assessment of paraspinal muscle fat infiltration in early stage ankylosing spondylitis patients by using MRI IDEAL sequence

作　　者：黄瑞滨[1] 杨宏武 苏树燕 陈柳江[1] 庄儒耀[1] 刘源[1] HUANG Ruibin;YANG Hongwu;SU Shuyan;CHEN Liujiang;ZHUANG Ruyao;LIU Yuan(Department of Radiology,The First Affiliated Hospital of Shantou University Medical College,Shantou 515000,China)

机构地区：[1]汕头大学医学院第一附属医院放射科,汕头515041

出　　处：《磁共振成像》2022年第1期26-30,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：2020年度汕头市医疗科技计划项目(编号:汕府科[2021]3号-68)。

摘　　要：目的采用磁共振非对称回波的最小二程估算法迭代水脂分离(iterative decomposition of water and fat with echo asymmetric and leastsquares estimation,IDEAL)序列定量评估早期强直性脊柱炎(ankylosing spondylitis,AS)患者下腰部(L3/4、L4/5水平)多裂肌、竖棘肌脂肪浸润情况,分析其脂肪分数(ƞ)与临床指标的相关性。材料与方法前瞻性纳入40例经临床诊断的早期AS患者(AS组)和41名年龄、性别、体质量指数相匹配的健康志愿者(对照组),行IDEAL序列检查,测量L3/4、L4/5竖棘肌、多裂肌ƞ值,同期收集AS组病程、红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)、巴斯强直性脊柱炎疾病活动指数(Bath Ankylosing Spondylitis Disease Activity Index,BASDAI)等临床指标。用独立样本t检验(或Mann-Whitney U检验)比较2组间定量资料。采用Spearman相关评价L3/4、L4/5多裂肌、竖棘肌ƞ值与临床指标的相关性。结果AS组L3/4及L4/5水平竖棘肌、多裂肌平均ƞ值均高于对照组[(0.28±0.09)vs.(0.24±0.05);(0.32±0.07)vs.(0.26±0.05);(0.31±0.07)vs.(0.28±0.06);(0.36±0.08)vs.(0.30±0.06)],差异均有统计学意义(P<0.05)。AS组L3/4、L4/5水平竖棘肌、多裂肌平均ƞ值与病程呈正相关(P<0.05),与ESR、CRP、BASDAI评分均无明显相关(P>0.05)。结论IDEAL序列能量化分析早期AS下腰部椎旁肌脂肪浸润情况,对临床治疗具有良好评估价值。Objective:To evaluate fat infiltration of the multifidus and erector spinal muscles of the lower waist(L3/4,L4/5 levels)of ankylosing spondylitis(AS)patients in early stage,and explore the correlation between them and clinical indicators.Materials and Methods:Using a prospective study,40 clinically diagnosedAS patients in early stage(AS group)41 healthy volunteers(control group)matched in age,sex,and body mass index,all subjects were evaluated using iterative decomposition of water and fat with echo asymmetric and leastsquares estimation(IDEAL)sequence examination,the fat fraction values(ƞ)of multifidus and erector muscles at the levels of L3/4 and L4/5 were measured respectively.The clinical indicators such as the course of disease,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)in AS group were collected during the same period.The independent samples t test(or Mann-Whitney U test)was used to compare the quantitative data between the two groups.Spearman correlation was used to evaluate the correlation betweenƞvalues of multifidus,erector spinae at the levels of L3/4 and L4/5 and clinical indicators.Results:The averageƞvalues of erector spinae and multifidus muscles at the levels of L3/4 and L4/5 in AS group were higher than those in the control group[(0.28±0.09)vs.(0.24±0.05);(0.32±0.07)vs.(0.26±0.05);(0.31±0.07)vs.(0.28±0.06);(0.36±0.08)vs.(0.30±0.06)],the differences were statistically significant(P<0.05).The averageƞvalues of erector spinae and multifidus muscles at the levels of L3/4 and L4/5 in AS group were positively correlated with the course of the disease(P<0.05),but were not significantly correlated with ESR,CRP,and BASDAI scores(P>0.05).Conclusions:IDEAL sequence could be used in the quantitative analysis of fat infiltration in lower lumbar paraspinal muscles in earlyAS patients with good evaluation value for clinical treatment.

关 键 词：脊柱炎 强直性 脊柱旁肌 脂肪浸润 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.23[医药卫生—诊断学]