基于定量MRI评估慢性下腰痛患者椎间盘退行性变与椎旁肌脂肪浸润的相关性  

Correlation Between Intervertebral Disc Degeneration and Paravertebral Muscle Fat Infiltration in Chronic Low Back Pain via Quantitative MRI

作　　者：蒋睿 罗敏[2] 冯福婷 刘璐思 陈梅泞 张琴 JIANG Rui;LUO Min;FENG Futing;LIU Lusi;CHEN Meining;ZHANG Qin(Department of Radiology,Zigong Fourth People's Hospital,Zigong 643000,China;不详)

机构地区：[1]西南医科大学附属医院放射科,四川泸州646000 [2]自贡市第四人民医院放射科,四川自贡643000 [3]西门子医疗系统有限公司磁共振科研部,上海200124 [4]西门子数字医疗科技(上海)有限公司成都分公司,四川成都610000

出　　处：《中国医学影像学杂志》2025年第3期326-330,共5页Chinese Journal of Medical Imaging

基　　金：2023年自贡市科技计划项目(2023YKY09)。

摘　　要：目的通过定量MRI探讨慢性下腰痛(CLBP)患者椎间盘退变与椎旁肌脂肪浸润的相关性。资料与方法回顾性收集2023年9月—2024年3月自贡市第四人民医院63例CLBP患者和42名志愿者,应用多回波水-脂分离技术和T2 mapping技术扫描。采用Pfirrmann分级评估椎间盘退变,Goutallier分级评估椎旁肌脂肪浸润,测量椎旁肌质子密度脂肪分数(PDFF)及髓核T2值,比较上述参数间及其与年龄、性别的关系。结果CLBP患者髓核T2值较志愿者显著降低、椎旁肌PDFF显著增加(Z=-5.54~4.65,P均<0.001)。椎间盘Pfirrmann分级和椎旁肌Goutallier分级均与髓核T2值和椎旁肌PDFF显著相关(|r|>0.4,P<0.05)。年龄和Pfirrmann分级是椎旁肌脂肪浸润的独立预测因子(β=0.228~5.682,P均<0.001),在L4/5椎间盘层面,性别也是独立预测因子(β=-2.834、-3.352,P均<0.05)。结论椎间盘退变与椎旁肌脂肪浸润在CLBP患者中密切相关,同时年龄和性别也存在影响。Purpose To investigate the correlation between intervertebral disc degeneration and paraspinal muscle fatty infiltration in chronic low back pain(CLBP)using quantitative MRI techniques.Materials and Methods A total of 63 CLBP patients and 42 volunteers in Zigong Fourth People's Hospital from September 2023 to March 2024 were retrospectively collected.Magnetic resonance scans were performed using multi-echo water-fat separation technique and T2 mapping technique.Intervertebral disc degeneration was assessed using the Pfirrmann grading,while paraspinal muscle fatty infiltration was evaluated using the Goutallier grading.Proton density fat fraction(PDFF)of the multifidus and erector spinae muscles,and T2 values of the nucleus pulposus were quantitatively measured.The relationships between these parameters and their associations with age and gender were analyzed.Results Compared with healthy volunteers,CLBP patients showed significantly reduced T2 values of the nucleus pulposusand significantly increased PDFF of the paraspinal muscles(Z=-5.54-4.65,all P<0.001).The Pfirrmann grading of intervertebral discs and the Goutallier grading of paraspinal muscles were significantly correlated with the T2 value of the nucleus pulposus and the PDFF of the paraspinal muscles(|r|>0.4,P<0.05).Age and Pfirrmann grading were independent predictors of paraspinal muscle fat infiltration(β=0.228-5.682,all P<0.001),and gender was also an independent predictor at the L4/5 intervertebral disc level(β=-2.834,-3.352,both P<0.05).Conclusion Intervertebral disc degeneration and paraspinal muscle fat infiltration are closely related in CLBP,age and gender also have an impact.

关 键 词：腰痛 椎间盘退化 椎旁肌 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R441.1[医药卫生—诊断学]