单节段腰椎间盘突出症多裂肌病变与病情程度的关系  

The Relationship Between Multifidus Lesion and Severity of Single Segment Lumbar Disc Herniation

作　　者：郭秀云 莫焕涛 Guo Xiuyun;Mo Huantao(The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou City,Guangdong Province 510378;不详)

机构地区：[1]广州中医药大学第三附属医院医学影像科,广东省广州市510378 [2]广州中医药大学第一附属医院影像科

出　　处：《医学理论与实践》2024年第10期1639-1643,共5页The Journal of Medical Theory and Practice

摘　　要：目的:探索单侧单节段(L_(4)/L_(5),L_(5)/S_(1))腰椎间盘突出症(LDH)多裂肌病变与病情程度的关系,为腰椎间盘突出及多裂肌病变的预防和治疗提供参考。方法:纳入本院2022年1—12月收治的单节段LDH患者92例为研究对象,行MRI(1.5T)检查,评估LDH发生节段及严重程度;根据T_(2)加权轴位MRI图像评价LDH病变对应节段患侧和健侧多裂肌横断面积(CSA)、平均信号强度(SIS)、脂肪浸润面积(FI)、脂肪浸润面积占比(FIT);将LDH严重程度分为膨出、突出、脱出、游离4个严重等级,对不同严重等级患者间患侧、健侧CSA、SIS、FI、FIT进行对比分析,并分析患侧、健侧CSA、SIS、FI、FIT与LDH严重程度间的相关性。结果:膨出、突出、脱出、游离4个严重等级患者患侧CSA均值分别为(764.15±78.40)mm^(2)、(727.23±89.06)mm^(2)、(694.87±85.64)mm^(2)、(613.38±93.23)mm^(2),健侧CSA均值分别为(786.07±83.20)mm^(2)、(771.617±84.53)mm^(2)、(759.43±86.82)mm^(2)、(722.68±81.61)mm^(2),差异有统计学意义,(P<0.05);患侧FI均值分别为(245.18±21.61)mm^(2)、(257.80±24.75)mm^(2)、(275.62±28.65)mm^(2)、(297.98±32.09)mm^(2),健侧FI均值分别为(224.01±18.89)mm^(2)、(232.53±21.14)mm^(2)、(244.57±24.49)mm^(2)、(262.39±33.16)mm^(2),差异有统计学意义(P<0.05);不同严重程度LDH患者患侧、健侧多裂肌SIS、FIT有显著差异(P<0.05)。多裂肌健侧、患侧CSA与LDH严重程度呈显著负相关(相关系数分别为-0.869、-0.847,P<0.05);患侧、健侧SIS、FI、FIT与LDH严重程度呈显著正相关(相关系数均>0.8,均P<0.05)。结论:单节段LDH患者多裂肌病变程度与LDH严重程度直接相关,表现出病变节段多裂肌横断面积减少,脂肪浸润面积增加的特征,LDH越严重多裂肌病变越严重,横断面积减少大于脂肪浸润面积增加幅度,患侧多裂肌受影响更为严重,健侧多裂肌同样受显著影响,但严重程度低于患侧。Objective:To explore the relationship between multifidus lesions and the severity of unilateral and single segment(L_(4)/L_(5),L_(5)/S_(1))lumbar disc herniation,and to provide reference for the prevention and treatment of lumbar disc herniation and multifidus lesions.Methods:92 single segment LDH patients admitted to our hospital from January 2022 to December 2022 were included as the study subjects,and MRI(1.5T)examination was performed to evaluate the occurrence and severity of LDH at the segment.Evaluate the cross-sectional area(CSA),average signal intensity(SIS),fat infiltration area(FI),and proportion of fat infiltration area(FIT)of the affected and healthy segments of LDH lesions based on T_(2)weighted axial MRI images.Divide the severity of LDH into four severity levels:bulging,protrusion,extrusion,and sequestration.Compare and analyze the CSA,SIS,FI,FIT of the affected and healthy sides of patients with different severity levels,and analyze the correlation between the CSA,SIS,FI,FIT of the affected and healthy sides and the severity of LDH.Results:The mean CSA values on the affected side of patients with four severity levels of bulging,protrusion,extrusion,and sequestration were(764.15±78.40)mm^(2),(727.23±89.06)mm^(2),(694.87±85.64)mm^(2),(613.38±93.23)mm^(2),respectively;the mean CSA values on the healthy side were(786.07±83.20)mm^(2),(771.617±84.53)mm^(2),(759.43±86.82)mm^(2),and(722.68±81.61)mm^(2),respectively,with statistically significant differences(P<0.05).The mean values of FI on the affected side were(245.18±21.61)mm^(2),(257.80±24.75)mm^(2),(275.62±28.65)mm^(2),(297.98±32.09)mm^(2),respectively;the mean values of FI on the healthy side were(224.01±18.89)mm^(2),(232.53±21.14)mm^(2),(244.57±24.49)mm^(2),(262.39±33.16)mm^(2),respectively,with statistically significant differences(P<0.05).There were significant differences in SIS and FIT between the affected and healthy sides of LDH patients with different severity levels(P<0.05).The correlation coefficients between the severity o

关 键 词：单节段 腰椎间盘突出 多裂肌病变 病变相关性 T_(2)加权轴位图像 

分 类 号：R681.53[医药卫生—骨科学]