合成MRI髓核质子密度值在腰椎间盘退变分级评估中的应用  

Application of Synthetic MRI by Nucleus Pulposus Proton Density in Grading Evaluation of Lumbar Disc Degeneration

作　　者：欧阳鸿 王虎[1] 顾聪 岳选彤 曹婷婷 朱琳 姚倩东[1] 刘丽[2] OUYANG Hong;WANG Hu;GU Cong;YUE Xuantong;CAO Tingting;ZHU Lin;YAO Qiandong;LIU Li(Radiology Department,Sichuan Science City Hospital,Sichuan 621900,China;Pain Department,Sichuan Science City Hospital,Sichuan 621900,China)

机构地区：[1]四川省科学城医院放射科,四川621900 [2]四川省科学城医院疼痛科,四川621900

出　　处：《影像科学与光化学》2025年第2期24-29,共6页Imaging Science and Photochemistry

基　　金：四川省医学科研课题(S19035)。

摘　　要：目的:探讨合成磁共振成像(MRI)髓核质子密度值在腰椎间盘退变分级评估中的应用价值,旨在为腰椎间盘退变的客观评估及个体化治疗方案提供科学依据。方法:回顾性分析2020年1月至2023年12月期间因腰痛就诊于我院的244例患者(933个腰椎间盘退变患者),所有患者均接受腰椎合成MRI检查。根据Pfirrmann分级系统对椎间盘进行分级,并比较不同分级组腰椎间盘合成MRI的定量参数(包括T1值、T2值和质子密度值)。采用Logistic回归分析评估定量参数与Pfirrmann分级的关系,并绘制受试者操作特征(ROC)曲线以评估髓核质子密度值在腰椎间盘退变分级评估中的效能。结果:研究发现,随着腰椎间盘退变程度的增加,髓核的T2值和质子密度值显著降低(P<0.05)。Logistic回归分析显示,髓核质子密度值与Pfirrmann分级显著相关(P<0.05)。ROC曲线分析表明,髓核质子密度值在鉴别I级与II级、II级与III级、III级与IV级腰椎间盘退变方面具有较高的诊断效能(AUC分别为0.79、0.75和0.84)。结论:合成MRI髓核质子密度值能够作为腰椎间盘退变分级评估的有效量化指标,尤其在I级至IV级退变鉴别中表现出色,为腰椎间盘退变的早期诊断和个体化治疗提供了有力支持。Objective:To investigate the application value of synthetic magnetic resonance imaging(MRI)nucleus pulposus proton density in grading evaluation of lumbar intervertebraldisc degeneration,aiming to provide a scientific basis for objective assessment and individualized treatment planning of lumbar intervertebral disc degeneration.Methods:A retrospective analysis was conducted on 244 patients with low back pain,who had a total of 933 lumbar intervertebral disc degenerationsand were treated in our hospital from January 2020 to December 2023.All these patients underwent lumbar synthetic MRI examination.The intervertebral discs were graded according to the Pfirrmann classification system,and quantitative parameters of lumbar intervertebral disc synthetic MRI(including T1 value,T2 value,and proton density)were compared among different grade groups.Logistic regression analysis was used to evaluate the relationship between quantitative parameters and Pfirrmann grades,and receiver operating characteristic(ROC)curves were plotted to assess the efficacy of proton density of the nucleus pulposus in grading lumbar intervertebral disc degeneration.Results:The study found that as the degree of lumbar intervertebral disc degeneration increased,the T2 value and proton density of the nucleus pulposus decreased significantly(P<0.05).Logistic regression analysis showed that the proton density of the nucleus pulposus was significantly correlated with the Pfirrmann grade(P<0.05).ROC curve analysis indicated that the proton density of the nucleus pulposus had high diagnostic efficacy in differentiating between grades I and II,II and III,and III and IV of lumbar intervertebral disc degeneration(with AUCs of 0.79,0.75,and 0.84,respectively).Conclusion:The proton density of the nucleus pulposus in synthetic MRI can serve as an effective quantitative indicator for grading lumbar intervertebral disc degeneration,particularly excelling in differentiating between grades.

关 键 词：核磁共振成像 髓核 质子密度 腰椎间盘 退变 

分 类 号：R681.57[医药卫生—骨科学]