MRI T2-mapping检查在颈椎间盘退行性变程度评估中的应用价值研究  

Application Value of MRI T2-mapping in Evaluation of Patients with Cervical Intervertebral Disc Degeneration

作　　者：王仓义 李月河 钱冬乐 程军 贾春岩[4] WANG Cang-yi;LI Yue-he;QIAN Dong-le;CHENG Jun;JIA Chun-yan(Department of Radiology,Luwan Branch of Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200020,China;Department of Radiology,Fengcheng Hospital of Fengxian District,Shanghai 201411,China;Department of Radiology,Central Hospital of Minhang District,Shanghai 201199,China;Department of Ultrasound,the Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院放射科,上海200020 [2]上海市奉贤区奉城医院放射科,上海201411 [3]上海市闵行区中心医院放射科,上海201199 [4]上海中医药大学附属市中医医院超声科,上海200071

出　　处：《临床误诊误治》2022年第5期65-68,共4页Clinical Misdiagnosis & Mistherapy

基　　金：上海市卫生局科研课题计划项目(2008188)。

摘　　要：目的探讨MRI T2-mapping检查在颈椎间盘退行性变程度评估中的价值。方法选取2020年2月—2021年5月我院53例受检者行常规颈椎MRI及T2-mapping扫描,行颈椎间盘Pfirrmann分级及髓核T2值测定,分析髓核T2值与Pfirrmann分级的相关性,绘制受试者工作特征(ROC)曲线分析髓核T2值对Pfirrmann分级的诊断准确度,同时比较不同年龄段、颈椎间盘节段髓核T2值。结果53例受检者共265个颈椎间盘,MRI髓核T2值随Pfirrmann分级升高而逐渐降低(P<0.01);不同Pfirrmann分级受检者MRI髓核T2值存在明显差异(P<0.05)。Spearman相关性分析显示,髓核T2值与Pfirrmann分级呈负相关(r=-0.673,P<0.01)。ROC曲线显示,髓核T2值诊断Ⅰ级和Ⅱ级、Ⅱ级和Ⅲ级、Ⅲ级和Ⅳ级颈椎间盘退行性变的准确度中等,曲线下面积分别为0.739、0.817及0.784。22~30岁受检者中,不同颈椎间盘节段MRI髓核T2值存在明显差异(P<0.01);31~45岁受检者不同颈椎间盘节段MRI髓核T2值明显小于22~30岁受检者(P<0.01)。结论MRI T2-mapping检查可用于颈椎间盘退行性变程度的评估,髓核T2值具有定量检测颈椎间盘退行性变程度的潜能,在疗效评估、病情监测等方面起重要作用。Objective To explore the value of MRI T2-mapping in evaluation of patients with cervical intervertebral disc degeneration(CIDD).Methods A total of 53 subjects between February 2020 and May 2021 were selected for examinations of routine cervical MRI and T2-mapping scanning.Pfirrmann grading of cervical intervertebral disc and T2 value of nucleus pulposus were measured.The correlation between T2 value of nucleus pulposus with Pfirrmann grading was analyzed,and receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic accuracy of T2 value of nucleus pulposus for Pfirrmann grading.T2 values of nucleus pulposus in different age groups and cervical intervertebral disc segments were compared.Results There were 265 cervical intervertebral discs in 53 subjects,and T2 values of MRI nucleus pulposus were decreased gradually with the increase of Pferrmann grade(P<0.01).There were significant differences in T2 values of MRI nucleus pulposus among subjects with different Pfirrmann grades(P<0.05).Spearman correlation analysis showed that T2 value of nucleus pulposus was negatively correlated with Pfirrmann grade(r=-0.673,P<0.01).ROC curve showed that accuracy levels of T2 value of nucleus pulposus in diagnosis of gradeⅠandⅡ,gradeⅡandⅢ,gradeⅢandⅣCIDD were moderate,and their areas under the ROC curve(AUC)were 0.739,0.817 and 0.784 respectively.There were significant differences in T2 values of nucleus pulposus on MRI in different cervical disc segments among subjects aged 22-30 years old(P<0.01).T2 values of MRI nucleus pulposus in different cervical disc segments of subjects aged 31-45 years old were significantly lower than that of subjects aged 22-30 years old(P<0.01).Conclusion MRI T2-mapping may be used to evaluate the degree of CIDD.T2 value of nucleus pulposus has the potential to quantitatively detect the degree of CIDD,and plays an important role in evaluation of curative effect and condition monitoring.

关 键 词：椎间盘退行性变 颈椎病 磁共振成像 T2-mapping检查 病变程度 诊断价值 

分 类 号：R681.53[医药卫生—骨科学]