磁共振单体素波谱成像技术评估退行性脊柱畸形患者多裂肌退变程度的初步临床研究  

Preliminary clinical study on the evaluation of multifidus muscle degeneration in patients with degener-ative spinal deformities using single-voxel magnetic resonance spectroscopy imaging technology

作　　者：陈春华 张承旻 陈灿 罗飞 Chen Chunhua;Zhang Chengmin;Chen Can;Luo Fei(Department of Orthopedics,The First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department for Combat Casualty Care Training,Training Base for Army Health Care,Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学学院附属西南医院骨科,重庆400038 [2]陆军军医大学陆军卫勤训练基地战救技能训练教研室,重庆400038

出　　处：《中华老年骨科与康复电子杂志》2024年第3期139-145,共7页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：重庆市科卫联合医学科研项目(2023ZDXM018);陆军军医大学优秀人才库重点扶持对象个性化培养方案(XZ-2019-505-021)。

摘　　要：目的探索磁共振单体素波谱(SMRS)成像技术定量评估退行性脊柱畸形患者多裂肌退变程度的技术方法,并探究多裂肌退变程度与脊柱矢状面失衡程度的关联。方法公开招募31例退行性脊柱畸形(DSD)患者(DSD组)以及30例健康志愿者(对照组)作为研究对象,所有受试者均行SMRS序列扫描并拍摄脊柱全长正侧位X片。磁共振扫描部位为L4\5椎间盘层面的双侧多裂肌,观察指标包括:脂肪分数(FF)、水脂比(W\F)、脂肪波峰下面积(FP)、不对称程度(DOA)。通过ROC曲线计算上述指标曲线下面积,观察两组人群多裂肌退变特点及其与矢状面平衡的关联。结果畸形组FF、FP、DOA高于对照组(P<0.05),畸形组W\F低于对照组(P<0.05),双侧多裂肌FF、FP、DOA、W\F的ROC曲线下面积分别为0.651、0.349、0.694、0.662,畸形组人群双侧多裂肌各退变指标与脊柱矢状面失衡程度未见明显相关性(P>0.05)。结论SMRS序列可以用于定量评估多裂肌退变情况,双侧多裂肌DOA可作为评估退行性脊柱畸形患者椎旁肌退变程度的敏感指标;多裂肌退变程度与脊柱矢状面失衡程度缺乏关联,前者可能是退行性脊柱畸形的独立影响因素。Objective To explore the technical method of using single voxel MR spectroscopy(SMRS)imaging technology to quantitatively evaluate the degree of multifidus muscle degeneration in pa-tients with degenerative spinal deformities,and explore the correlation between multifidus muscle degenera-tion and spinal sagittal imbalance.Methods 31 patients with degenerative spinal deformity(DSD)(DSD group)and 30 healthy volunteers(control group)were publicly recruited as research subjects.All subjects un-derwent SMRS sequence scanning and underwent full length anteroposterior and lateral X-rays of the spine.The magnetic resonance imaging scan was performed on bilateral multifidus muscles at the L4-5 interverte-bral disc level,with observed indicators including fat fraction(FF),water fat ratio(W/F),fat peak(FP),and degree of asymmetry(DOA).Calculate the area under the above indicator curve using the ROC curve,and ob-serve the characteristics of multifidus muscle degeneration and its correlation with sagittal balance in two groups of people.Results The FF,FP,and DOA levels in the DSD group were higher than those in the con-trol group(P<0.05),while the W F levels in the DSD group were lower than those in the control group(P<0.05).The areas under the ROC curves of bilateral multifidus muscle FF,FP,DOA,and W F were 0.651,0.349,0.694,and 0.662,respectively.There was no significant correlation between the various degeneration indicators of bilateral multifidus muscle in the DSD group and the degree of spinal sagittal imbalance(P>0.05).Conclusion The SMRS sequence can be used to quantitatively evaluate the degree of multifidus mus-cle degeneration,and bilateral multifidus muscle DOA can be a sensitive indicator for evaluating the degree of paravertebral muscle degeneration in patients with degenerative spinal deformities;There is a lack of corre-lation between the degree of multifidus degeneration and the degree of spinal sagittal imbalance,and the for-mer may be an independent influencing factor for degenerative spinal deformities.

关 键 词：退行性脊柱畸形 多裂肌 磁共振单体波谱 

分 类 号：R68[医药卫生—骨科学]