MRI成像Dixon-VIBE序列定量评估退行性腰椎管狭窄症患者椎旁肌退变程度的价值  

The value of MRI imaging Dixon-VIBE sequence in quantitatively evaluating the degree of paravertebral muscle degeneration in patients with degenerative lumbar spinal stenosis

作　　者：李刚 谭德力 管龙 陈晨 褚江东 LI Gang;TAN Deli;GUAN Long;CHEN Chen;CHU Jiangdong(Department of Radiology,901 Hospital of Joint Logistics Support Force of Chinese PLA,Hefei 230031)

机构地区：[1]解放军联勤保障部队第901医院放射诊断科,合肥230031

出　　处：《颈腰痛杂志》2025年第2期218-222,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨MRI成像Dixon-VIBE序列定量评估退行性腰椎管狭窄症(DLSS)患者椎旁肌退变程度的价值。方法选取2020年3月至2022年4月解放军联勤保障部队第901医院收治的41例DLSS患者为观察组,另选取同时期门诊体检的健康者35例为健康对照组,均接受3.0T MRI Dixon椎旁肌成像。重复测量横断位图像L 4-5椎间盘中心层面椎旁肌横截面积(CSA)、脂肪信号强度(SIfat)、水信号强度(SIwater),计算脂肪分数(FF)。采用组间相关系数(ICC)评估竖脊肌、腰大肌、多裂肌的CSA和FF的观察者间变异性,比较观察组和对照组患者Dixon-VIBE序列成像上椎旁肌形态测量结果,分析椎旁肌CSA和FF不对称度异常情况。结果两位观察者对观察组患者的竖脊肌、腰大肌、多裂肌CSA和FF测量的组内ICC为0.775~0.962,组间ICC为0.781~0.947;对对照组患者的竖脊肌、腰大肌、多裂肌CSA和FF测量的组内ICC组内ICC为0.845~0.984,组间ICC为0.859~0.975,测量结果均具有较好一致性。两组患者竖脊肌CSA、腰大肌CSA、腰大肌FF、多裂肌CSA比较,差异无统计学意义(P>0.05)。观察组竖脊肌FF、多裂肌FF明显高于对照组,差异有统计学意义(P<0.05)。观察组中竖脊肌、腰大肌、多裂肌的CSA不对称度>10%患者分别有18、25、14例,竖脊肌、腰大肌、多裂肌的FF不对称度>10%患者分别有10、3、6例。结论DLSS患者L_(4-5)水平椎旁肌退变以多裂肌、竖脊肌FF增加,不对称性退变以CSA增大为主,采取MRI Dixon-VIBE序列用于评估DLS患者椎旁肌退变程度具有良好价值。Objective To investigate the value of MRI Dixon-VIBE sequence in quantitative evaluation of paravertebral muscle degeneration in patients with degenerative lumbar spinal stenosis(DLSS).Methods From March 2020 to April 2022,41 patients with DLSS admitted to the 901 st Hospital of the Joint Logistics Support Force of the People's Liberation Army were selected as the observation group,and 35 healthy people who underwent outpatient physical examination at the same time were selected as the healthy control group.All patients underwent 3.0 T MRI Dixon paravertebral muscle imaging.The cross-sectional area(CSA),fat signal intensity(SIfat),water signal intensity(SIwater)and fat fraction(FF)of the paraspinal muscles at the central level of L 4-5 intervertebral discs were measured repeatedly.The inter-observer variability of CSA and FF of erector spinae,psoas major and multifidus muscles was evaluated by inter-group correlation coefficient(ICC).The morphological measurement results of paravertebral muscles on Dixon-VIBE sequence imaging were compared between the observation group and the control group,and the abnormalities of CSA and FF asymmetry of paravertebral muscles were analyzed.Results The intra-group ICC of CSA and FF of erector spinae,psoas major and multifidus muscles measured by the two observers was 0.775-0.962,and the inter-group ICC was 0.781-0.947.The ICC of erector spinae,psoas major and multifidus muscle CSA and FF in the control group was 0.845-0.984,and the ICC between groups was 0.859-0.975.There was no significant difference in erector spinae CSA,psoas CSA,psoas FF and multifidus CSA between the two groups(P>0.05).The FF of erector spinae and multifidus in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P10%:18,25,14 cases,respectively).The FF asymmetry of erector spinae,psoas major and multifidus>10%:10,3,6 cases,respectively.Conclusion The degeneration of paravertebral muscles at L_(4-5)levels in patients with DLSS is mai

关 键 词：MRI成像 多回波三维容积内插水脂分离快速扰相序列 退行性腰椎管狭窄症 椎旁肌 横截面积 脂肪分数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R687.3[医药卫生—诊断学]