基于HISTO及qDixon对慢性下腰痛患者椎旁肌肉脂肪的定量研究  

A quantitative study of paravertebral muscle fat in patients with chronic low back pain based on HISTO and qDixon

作　　者：陈开阳 阳丹萍 杜宁芳 傅彩霞 李仕红 Chen Kaiyang;Yang Danping;Du Ningfang;Fu Caixia;Li Shihong(Department of Orthopedics,People's Hospital of Rugao City,Nantong University,Rugao,Jiangsu,226500,P.R.China;De-partment of Radiology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Application Develop-ment Department of Siemens(Shenzhen)Magnetic Resonance Co.,Ltd,Shenzhen,Guangdong,518057,P.R.China)

机构地区：[1]南通大学附属如皋市人民医院骨科,江苏如皋226500 [2]复旦大学附属华东医院放射科,上海200040 [3]西门子(深圳)磁共振有限公司应用开发部,深圳518057

出　　处：《老年医学与保健》2023年第2期361-366,376,共7页Geriatrics & Health Care

摘　　要：目的 使用HISTO及qDixon定量慢性下腰痛(CLBP)患者椎旁肌肉脂肪含量,探讨两种技术定量肌肉脂肪的一致性。方法 入组42例CLBP患者[女性28例,平均年龄(70.7±7.6)岁]及21例正常对照者[女性17例,平均年龄(66.0±8.5)岁],均行常规腰椎MRI平扫成像,并使用快速T2校正的多回波(HISTO)MR波谱技术、 qDixon定量腰4水平竖脊肌、多裂肌内的脂肪分数,比较两种技术的相关性。使用t检验比较CLBP组和正常对照组之间椎旁肌肉脂肪含量的差异。用Bland-Altman图来量化来自qDixon成像和HISTO波谱成像的脂肪信号分数之间的一致性。结果 Pearson线性相关分析显示,纳入的63例被试(42例CLBP和21例健康对照),采用多回波HISTO序列和qDixon测得椎旁肌肉的脂肪分数值FF呈正相关(左侧竖脊肌,r=0.981;左侧多裂肌,r=0.978;右侧竖脊肌,r=0.967;右侧多裂肌,r=0.977;所有P<0.001)。Bland-Altman分析显示:在左竖脊肌、右竖脊肌与左多裂肌、右多裂肌内使用HISTO和qDixon所测定的脂肪分数之差的平均值分别为-0.9%(95%CI:2.7%~-4.5%),-1.9%(95%CI:3.1%~-6.8%),-1.8%(95%CI:2.6%~-6.2%)和-2.2%(95%CI:2.1%~-6.5%)。CLBP组患者的双侧竖脊肌、多裂肌通过HISTO获得的脂肪分数高于正常对照组(所有P<0.001)。结论 单体素波谱HISTO成像与多回波qDixon定量肌肉脂肪分数的结果密切相关,且具有高度一致性,CLBP组患者椎旁肌肉脂肪分数高于正常对照组,基于磁共振成像对椎旁肌肉脂肪分数定量有助于对CLBP的深入理解。Objective High⁃speed T2⁃corrected multiple⁃echo MR spectroscopy(HISTO)and qDixon were used to quantify paravertebral muscle fat content in patients with chronic low back pain(CLBP),and the consistency of the two tech⁃niques in quantifying muscle fat was explored.Methods 42 patients with CLBP[28 females,average age(70.7±7.6)years]and 21 normal controls[17 females,average age(66.0±8.5)years]were enrolled in the study,and all of them un⁃derwent conventional lumbar spine MRI plain scan imaging.HISTO and qDixon were used to quantify the fat fraction(FF)of the erector spinae and multifidus at the level of lumbar 4,and the correlation between the two techniques was compared.The t⁃test was used to compare the difference in paravertebral muscle fat content between the CLBP group and the normal control group.Bland⁃Altman plots were used to quantify the consistency between FF from qDixon imaging and HISTO spectral ima⁃ging.Results Pearson linear correlation analysis showed that in 63 included subjects(42 CLBP patients and 21 healthy con⁃trols),FF of paravertebral muscle measured by qDixon was positively correlated with that measured by HISTO(left erector spi⁃nae,r=0.981;left multifidus,r=0.978;right erector spinae,r=0.967;right multifidus,r=0.977;all P<0.001).Bland⁃Altman analysis showed the average difference in the FF value between HISTO and qDixon were-0.9%(95%CI:2.7%to-4.5%),-1.9%(95%CI:3.1%to-6.8%),-1.8%(95%CI:2.6%to-6.2%),and-2.2%(95%CI:2.1%to-6.5%)for the left erector spinae,right erector spinae,left multifidus and right multifidus,respectively.The FF of bilateral erector spinae and multifidus measured by HISTO in the CLBP group were significantly higher than those in the normal control group(all P<0.001).Conclusion The FF measured by single⁃voxel spectroscopy HISTO is highly consistent with that measured by multi⁃echo qDixon.The paravertebral muscle FF of CLBP patients was higher than that of normal controls.The quantification of paravertebral muscle FF based on magnetic resonance imaging

关 键 词：快速T2校正的多回波(HISTO)MR波谱技术 定量Dixon 慢性下腰痛 磁共振成像 

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]