能谱CT水-肌物质分离技术评估青年慢性非特异性腰痛椎旁肌水含量  

Revolution CT Water-muscle Decomposition Techniques for Evaluating Water Content of Paraspinal Muscles in Youne Patients with Chronic Nonspecific Low Back Pain

作　　者：周晓娜 罗慕晴 刘音其 向剑 钟泽亚 黎建宇 张堃[1,2] ZHOU Xiao-na;LUO Mu-qing;LIU Yin-qi;XIANG Jian;ZHONG Ze-ya;LI Jian-yu;ZHANG Kun(Department of Radiology,the First Hospital of Hunan University of Chinese Medicine,Changsha 410007,Hunan Province,China;College of Integrated Traditional Chinese and Western Medicine,Hunan University of Chinese Medicine,Changsha 410208,Hunan Province,China)

机构地区：[1]湖南中医药大学第一附属医院放射影像科,湖南长沙410007 [2]湖南中医药大学中西医结合学院,湖南长沙410208

出　　处：《中国CT和MRI杂志》2025年第1期177-179,共3页Chinese Journal of CT and MRI

基　　金：湖南中医药大学重点学科建设项目(4906-0002091006);湖南省科技人才托举工程项目-年轻优秀科技工作者培养计划(2022TJ-N05);湖南省教育厅科学研究项目(22B0401);长沙市自然科学基金(kq2208211);湖南省自然科学基金(2023JJ30477)。

摘　　要：目的 通过能谱CT水-肌物质分离技术比较慢性非特异性下腰痛(CNLBP)青年患者的椎旁肌水含量变化,并评估椎旁肌水含量诊断青年CNLBP的价值。方法 本项研究前瞻性招募56名CNLBP患者和54例健康志愿者进行能谱CT成像,获取L1~L4椎体水平竖脊肌及L2~L5椎体水平多裂肌水含量。采用独立样本t检验分析两组间水含量的差异,以临床诊断为标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估椎旁肌水含量诊断青年CNLBP的效能。结果 CNLBP患者各椎体层面竖脊肌及多裂肌水含量均高于于健康志愿者。CNLBP患者于L4及L5椎体多裂肌水平高于健康志愿者,差异具统计学意义(t=2.48,P=0.015;t=4.41,P<0.001)。L4、L5层面多裂肌水含量诊断青年CNLBP的AUC分别为0.633、0.729。结论 能谱CT水-肌物质分离技术可以敏感、定量评估CN LBP青年患者椎旁肌水含量升高的改变,可为CNLBP的诊断与治疗评估提供一定的临床价值。Objective The purpose of this study was to compare changes of the water content of paraspinal muscles for young patients with non-specific low back pain(CNLBP)by Revolution CT water-muscle decomposition techniques,and evaluate the value of paraspinal muscles water content for diagnosing young patients with CNLBP.Methods This institutional review board-approved study included 56patients with CNLBP and 54 cases of asymptomatic participants who underwent Revolution CT imaging examination of the spine.Obtaining the water content of L1-L4 levels for erector spinae muscle,L2-L5 for multifidus.Independent samples t-test was used to analyze the difference of water content between two groups.Based on the results of clinical diagnosis of CNLBP,the receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated,assessing the efficacy of paraspinal muscles water content in diagnosing CNLBP in young patients.Results The water content of the erector spinae and multifidus muscles was higher in patients with CNLBP than in asymptomatic participants at all vertebral levels.The water content of the multifidus muscle was higher in CNLBP patients than in asymptomatic participants at the L4 and L5 levels,and the difference was statistically significant(t=2.48,P=0.015;t=4.41,P<0.001).AUC of water content of multifidus muscle at the L4、L5 level for diagnosing CNLBP in young patients were 0.633 and 0.729.Conclusion Revolution CT water-muscle decomposition techniques can ensitively and quantitatively assess the alteration of elevated paravertebral muscle water content in young patients with CNLBP,which can provide certain clinical value for the diagnosis and treatment evaluation of CNLBP.

关 键 词：能谱CT 竖脊肌 多裂肌 慢性非特异性下腰痛 

分 类 号：R681.57[医药卫生—骨科学]