健康人椎旁肌退变的影像学参数及其影响因素  

Radiographic parameters and influencing factors of paraspinal muscle degeneration in healthy people

作　　者：王伟[1] 李危石[2] WANG Wei;LI Weishi(Department of Orthopedics,Tianjin Hospital,Tianjin,300211,P.R.China;Department of Orthopedics,Peking University Third Hospital,Beijing,100191,P.R.China)

机构地区：[1]天津市天津医院骨科,天津300211 [2]北京大学第三医院骨科,北京100191

出　　处：《中国修复重建外科杂志》2024年第7期880-888,共9页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的测量健康人椎旁肌影像学参数,阐明椎旁肌特点及变化规律,探究椎旁肌退变的影响因素。方法2020年2月—11月前瞻性招募82名健康志愿者,男36名,女46名;年龄21~75岁,平均48.0岁。身高150~183 cm,平均165.6 cm;体质量43~100 kg,平均65.4 kg;身体质量指数(body mass index,BMI)16.7~32.4 kg/m^(2),平均23.7 kg/m^(2)。采用MRI测量L_(3)、L_(4)、L_(5)3个层面椎旁肌(多裂肌、竖脊肌和腰大肌)影像学参数,包括相对总横截面积(relative total cross-sectional area,rtCSA)、相对脂肪横截面积(relative fatty cross-sectional area,rfCSA)、相对信号强度(relative signal intensity,rSI)及脂肪浸润比(fatty infiltration,FI)。比较不同性别以及不同测量层面椎旁肌参数差异;通过Pearson或Spearman相关分析探究椎旁肌参数与年龄、身高、体质量、BMI之间的关系。结果从L_(3)至L_(5)层面,多裂肌、腰大肌rtCSA、rfCSA及竖脊肌rfCSA逐渐增加,竖脊肌rtCSA逐渐减小;各椎旁肌的FI、rSI均逐渐增加。L_(4)、L_(5)层面各椎旁肌各参数与L_(3)层面比较差异均有统计学意义(P<0.05);而L_(4)层面与L_(5)层面比较,多裂肌rtCSA、rfCSA,竖脊肌rtCSA、FI、rSI,以及腰大肌rtCSA、rfCSA、FI差异有统计学意义(P<0.05)。女性各腰椎层面多裂肌rfCSA和FI、竖脊肌FI、腰大肌FI高于男性,腰大肌rtCSA低于男性(P<0.05)。年龄与各椎旁肌rtCSA成负相关(P<0.05),与各椎旁肌FI及多裂肌和竖脊肌rfCSA、rSI成正相关(P<0.05)。身高与各椎旁肌rfCSA、FI成负相关(P<0.05)。结论沿脊柱轴线从头端至尾端,椎旁肌退变程度逐渐增加;椎旁肌退变和年龄、身高、性别相关,体质量、BMI和椎旁肌退变关系需要进一步研究。Objective To measure the paraspinal muscle parameters,explore the characteristics of paraspinal muscles,and investigate the influence factors of paraspinal muscle degeneration in healthy people.Methods Eighty-two healthy Chinese people were prospectively recruited between February 2020 and November 2020,including 36 males and 46 females.The age ranged from 21 to 75 years,with a mean of 48.0 years.The height ranged from 150 to 183 cm,with a mean of 165.6 cm.The body mass ranged from 43 to 100 kg,with a mean of 65.4 kg.The body mass index(BMI)ranged from 16.7 to 32.4 kg/m^(2),with a mean of 23.7 kg/m^(2).Parameters of the paraspinal muscles(multifidus muscle,erector spinae muscle,and psoas major muscle)at L_(3),L_(4),and L_(5) levels were measured by MRI,including the relative total crosssectional area(rtCSA),relative fatty cross-sectional area(rfCSA),relative signal intensity(rSI),and fatty infiltration(FI).The differences of paraspinal muscle parameters at different genders and different measurement levels were compared;Pearson or Spearman correlation analysis was used to explore the relationship between paraspinal muscle parameters and age,height,body mass,BMI.Results From L_(3) to L_(5) level,the rtCSA and rfCSA of multifidus muscle and psoas major muscle as well as the rfCSA of erector spinae muscle increased,while rtCSA of erector spinae muscle decreased.The FI and rSI of paraspinal muscles increased gradually.The parameters of paraspinal muscles at L_(4) and L_(5) levels were significantly different from those at L_(3) levels(P<0.05).There were significant differences in rtCSA and rfCSA of multifidus muscle,rtCSA,FI,and rSI of erector spinae muscle as well as rtCSA,rfCSA,and FI of psoas major muscle between L_(4) and L_(5) levels(P<0.05).Compared with males,the rfCSA and FI of multifidus muscle,FI of erector spinae muscle,and FI of psoas major muscle were significantly higher in females,while the rtCSA of psoas major muscle was significantly lower(P<0.05).Age was significantly negatively correlated with rtCS

关 键 词：多裂肌 竖脊肌 腰大肌 椎旁肌退变 健康人 

分 类 号：R681.5[医药卫生—骨科学]