定量CT与化学位移编码磁共振成像测量椎旁肌肉脂肪含量的相关性研究  

Comparisons of paraspinal muscle fat content measured by quantitative CT versus chemical shift encoded MRI

作　　者：张雯双 王玲[1] 郎昭[2] 闫东[1] 郭安忆 程克斌[1] 李凯[1] 黄朋举 程晓光[1] 刘亚军[2] ZHANG Wenshuang;WANG Ling;LANG Zhao;YAN Dong;GUO Anyi;CHENG Kebin;LI Kai;HUANG Pengju;CHENG Xiaoguang;LIU Yajun(Department of Radiology,Beijing Jishuitan Hospital,Beijing 100035;Department of Spinal Surgery,Beijing Jishuitan Hospital,Beijing 100035;Extracorporeal Shock Wave Therapy Room,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院放射科,北京100035 [2]北京积水潭医院脊柱外科,北京100035 [3]北京积水潭医院骨科冲击波治疗中心,北京100035

出　　处：《中华骨与关节外科杂志》2022年第9期669-674,共6页Chinese Journal of Bone and Joint Surgery

基　　金：北京市自然科学基金-海淀原始创新联合基金资助项目(L202011);青年北京学者(2020-025);北京市医院管理中心“登峰”人才计划(DFL20220401);北京市医院管理中心青年人才培养“青苗”计划(QML20200401,QML20200402);北京市医院管理中心临床医学发展专项经费资助(ZYLX202107)。

摘　　要：目的:比较、分析定量CT(QCT)和化学位移编码磁共振成像(CSE-MRI)对社区人群椎旁肌肉脂肪含量测量结果的一致性和相关性。方法:对117名社区志愿者进行腰椎QCT和CSE-MRI扫描。选取L2椎体下终板层面,分别测量竖脊肌和腰大肌的CT脂肪百分数(CTFF)和质子密度脂肪分数(PDFF)。绘制直方图观察CTFF和PDFF的分布,绘制相关性散点图并采用Spearman相关性分析法计算CTFF和PDFF测量值间的相关性。采用Bland-Altman分析法探讨CTFF和PDFF之间的一致性。同一肌肉CTFF和PDFF之间的差异比较采用配对样本的Wilcoxon符号秩和检验。结果:竖脊肌、腰大肌的CTFF与PDFF测量值呈正相关(r=0.939,P<0.001;r=0.899,P<0.001)。Bland-Altman分析示竖脊肌、腰大肌CTFF与PDFF测量结果之间均具有较高一致性,差值均数分别为0.05%、0.06%。Wilcoxon符号秩和检验显示竖脊肌、腰大肌CTFF与PDFF之间的差异均无统计学意义(Z=-0.221、-0.406,P=0.830、0.690)。结论:QCT和CSE-MRI对椎旁肌肉脂肪百分数的定量测量结果具有明显相关性和较好的一致性,QCT可用于评价椎旁肌肉脂肪浸润程度,未来可能得到更广泛的应用。Objective: To compare the agreement and correlation of measurements of paraspinal muscle fat content between quantitative CT(QCT) with chemical shift encoded MRI(CSE-MRI) in community volunteers. Methods: Lumbar spine QCT and CSEMRI examinations were performed in 117 individuals in this study. The CT fat fraction(CTFF) and MR proton density fat fraction(PDFF) values of erector spinae(ES) and psoas(PS) were measured at the level of the L2 inferior endplate. CTFF and PDFF were plotted as histograms. Scatterplots, Bland-Altman plots and Spearman correlation coefficients were used to examine the relationship between CTFF and PDFF. The comparisons between CTFF and PDFF were investigated by the Wilcoxon signed rank test. Results:CTFF of paraspinal muscle was positively correlated with PDFF(ES: r=0.939, P<0.001;PS: r=0.899, P<0.001). Bland-Altman analysis revealed good agreement between CTFF and PDFF, with an average difference in ES of 0.05% and PS of 0.06%. The difference between CTFF and PDFF of paraspinal muscle was statistically insignificant(ES: Z=-0.221, P=0.830;PS: Z=-0.406, P=0.690).Conclusions: QCT exhibits good correlation and consistency with the CSE-MRI method in quantifying paraspinal muscle fat content.In the future, QCT may serve as a reliable tool for quantitative analysis of paraspinal muscle fatty infiltration.

关 键 词：椎旁肌 脂肪浸润 脂肪定量分析 定量CT 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]