颈椎椎旁肌横截面积、脂肪含量与椎间盘退变关系的定量MRI研究  

A Quantitative MRI Research of the Relationship between Paravertebral Muscle Fat Content,Cross-sectional Area and Intervertebral Disc Degeneration in the Cervical Spine

作　　者：王怡 刘伟伟[2] 李子辰 WANG Yi;LIU Weiwei;LI Zichen(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan,Shandong Province 250013,P.R.China)

机构地区：[1]山东中医药大学第一临床医学院,济南250013 [2]山东中医药大学附属医院放射科,济南250011

出　　处：《临床放射学杂志》2025年第2期343-349,共7页Journal of Clinical Radiology

摘　　要：目的采用mDIXON-Quant技术定量测定颈椎椎旁肌脂肪含量、横截面积,评价颈椎椎旁肌[头夹肌(SPL)、头半棘肌(SCap)、颈半棘肌(SCer)、多裂肌(MF)]脂肪含量、横截面积与椎间盘退变之间的关系。方法共招募因临床慢性颈痛或颈部不适患者81例(男30例,女51例),采用Philips 3.0 T MRI扫描,根据Pfirrmann分级标准对颈椎间盘退变患者进行椎间盘退变分级,后处理获取C_(4~5)、C_(5~6)椎间盘相对应中心层面椎旁肌的脂肪含量百分比(FI)和横截面积(CSA)。C_(4~5)、C_(5~6)层面不同颈椎椎间盘退变程度分级与相对应的椎旁肌FI、CSA的差异采用ANOVA单因素方差分析比较;两层面间不同颈椎间盘的退变程度分级与相对应的椎旁肌FI、CSA的相关性用Spearman相关性研究;进一步对颈椎椎旁肌的FI、CSA的影响因素则使用多元线性回归分析处理。结果C_(4~5)、C_(5~6)层面不同颈椎间盘退变程度分级的患者与椎旁肌FI差异具有统计学意义(P<0.001),随着椎间盘退变程度越高,椎旁肌的FI越大。而椎间盘退变程度分级与椎旁肌SPL、SCap、MF+SCer的CSA之间差异不具有统计学意义(P>0.05)。通过相关性分析表明,C_(4~5)、C_(5~6)层面椎间盘退变程度分级与椎旁肌SPL、SCap、MF+SCer的FI均呈正相关,r值在C_(4~5)层面分别为0.487、0.459、0.581;C_(5~6)层面分别为0.474、0.493、0.559,由此可发现与MF+SCer的FI关系最为密切为强相关。通过多元线性回归发现颈椎间盘退变程度分级是SPL、SCap、MF+SCer的FI的独立影响因素;性别和年龄是SPL、SCap、MF+SCer的CSA的影响因素。结论颈椎间盘退变程度分级与椎旁肌SPL、SCap、MF+SCer的FI存在相关性;颈椎间盘退变程度分级是SPL、SCap、MF+SCer的FI的独立影响因素,性别和年龄是SPL、SCap、MF+SCer的CSA的影响因素。Objective Measure the fat content and cross-sectional area of cervical paravertebral muscles quantitatively by mDIXON-Quant technology,and evaluate the relationship in the fat content of cervical paravertebral muscles[Splenius capitis(SPL),Semispinalis capitis(SCap),Semispinalis cervicis(SCer),and Multifidus(MF)]cross-sectional area and disc degeneration.Methods A total of 81 patients(30 males and 51 females)with chronic neck pain or neck discomfort were enrolled.The cervical spine was scanned with Philips 3.0 T MRI.The patients with cervical disc degeneration were graded for disc degeneration according to the Pfirrmann grading criteria,and the post-processing workstation was applied to calculate the fat content percentage fat infiltration(FI)and cross-sectional area(CSA)of the paraspinal muscles at the corresponding center levels of the C_(4~5) and C_(5~6) discs were calculated using a post-processing workstation.The differences of paravertebral muscle FI and CSA corresponding to different degrees of cervical disc degeneration between C_(4~5) and C_(5~6) were compared by ANOVA(Analysis of Variance)one-way analysis of variance,the correlation between the degree of cervical disc degeneration and the corresponding paravertebral muscle FI and CSA between the two layers was measured by Spearman correlation,and the influencing factors of cervical paravertebral muscle FI and CSA were treated by multiple linear regression analysis.Results There were statistically significant differences in the FI of paravertebral muscles between patients with different grades of cervical disc degeneration at the C4-5 and C5-6 levels(P<0.001),and the FI of the paraspinal muscles was larger with the higher degree of the disc degeneration grade.In contrast,the differences between disc degeneration grade and CSA of paraspinal muscle SPL,SCap,MF+SCer were not statistically significant(P>0.05).Correlation analysis showed that the disc degeneration degree grading at the C_(4~5) and C_(5~6) levels were positively correlated with the FI of parav

关 键 词：颈椎椎旁肌 肌肉脂肪含量 肌肉横截面积 颈椎间盘退变 mDIXON-Quant 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]