功能MRI T1ρ定量评价腰椎间盘退变的Meta分析  

A Meta-analysis of quantitative evaluation of lumbar intervertebral disc degeneration by functional MRI T1ρ

作　　者：何敢声 薛丛洋 王智成 谢林[1,2] HE Gansheng;XUE Congyang;WANG Zhicheng;XIE Lin(Department of Orthopedics,the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;the Third Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学附属中西医结合医院骨伤科,江苏南京210023 [2]南京中医药大学第三临床医学院,江苏南京210023

出　　处：《实用放射学杂志》2024年第2期261-265,310,共6页Journal of Practical Radiology

基　　金：江苏省中医药科技发展项目(ZD202008);江苏省自然科学基金项目(BK20221420);江苏省中医药研究院高质量研究成果后补助项目(HBZ2021-005)。

摘　　要：目的利用Meta分析探讨基于Pfirrmann分级腰椎间盘退变(IVDD)过程中T1ρ值的变化规律。方法检索自建库至2022年12月20日采用T1ρ成像技术定量评估IVDD的文献,英文数据库检索PubMed、EMBASE、Cochrane Library,中文数据库检索中国知网、万方数据、维普、Sinomed。采用RevMan 5.4和Stata 14.0软件进行Meta分析。结果共纳入12项研究,纳入PfirrmannⅠ~Ⅴ级腰椎间盘的个数分别为316个、1460个、769个、430个、98个。随着退变等级增加,腰椎间盘T1ρ弛豫时间均呈逐渐下降的趋势。Ⅰ级腰椎间盘T1ρ值明显高于Ⅱ级[加权均数差(WMD)=14.55,95%置信区间(CI)6.35~22.75,P<0.01],Ⅱ级腰椎间盘T1ρ值显著高于Ⅲ级(WMD=34.20,95%CI 27.05~41.34,P<0.01),Ⅲ级腰椎间盘T1ρ值显著高于Ⅳ级(WMD=22.94,95%CI 17.08~28.80,P<0.01),Ⅳ级腰椎间盘T1ρ值高于Ⅴ级(WMD=9.35,95%CI 6.81~11.89,P<0.01)。结论T1ρ成像技术可客观定量评价不同退变时期的椎间盘,尤其对早中期IVDD敏感,可以为临床诊断早期IVDD提供影像学依据。Objective To investigate the change rule of T1ρvalue in the process of lumbar intervertebral disc degeneration(IVDD)based on Pfirrmann grading by Meta-analysis.Methods PubMed,EMBASE,Cochrane Library,CNKI,Wanfang Data,VIP and Sinomed were searched to collect studies on quantitative assessment of IVDD using T1ρimaging technology.The retrieval time limit was from the establishment of the database to December 20,2022.Meta-analysis was performed using RevMan 5.4 and Stata 14.0 software.Results A total of 12 articles were included,and the numbers of Pfirrmann gradeⅠ-Ⅴlumbar discs were 316,1460,769,430 and 98,respectively.T1ρrelaxation time decreased gradually with the increase of the grade of degeneration.The T1ρvalues of gradeⅠlumbar discs were significantly higher than those of gradeⅡlumbar discs[weighted mean difference(WMD)=14.55,95%confidence interval(CI)6.35-22.75,P<0.01],and the T1ρvalues of gradeⅡlumbar discs were significantly higher than those of gradeⅢlumbar discs(WMD=34.20,95%CI 27.05-41.34,P<0.01).The T1ρvalues of gradeⅢlumbar discs were significantly higher than that of gradeⅣlumbar discs(WMD=22.94,95%CI 17.08-28.80,P<0.01).The T1ρvalues of gradeⅣlumbar discs were significantly higher than that of gradeⅤlumbar discs(WMD=9.35,95%CI 6.81-11.89,P<0.01).Conclusion T1ρimaging technology can objectively and quantitatively evaluate degeneration at different stages,especially sensitive to IVDD in the early and middle stages,which can provide imaging evidence for clinical diagnosis of early IVDD.

关 键 词：T1ρ弛豫时间 Pfirrmann分级 磁共振成像 腰椎 椎间盘退变 META分析 

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]