摘要
目的：探讨扩散张量成像（DTI）定量指标ADC及FA值与腰椎间盘退行性改变Pfirrmann分级的相关性。方法：将105例腰腿痛患者纳入研究，所有患者行椎间盘常规MRI及矢状面DTI扫描，根据T2WI上椎间盘的特点对525个腰椎椎间盘进行Pfirrmann（Pm）分级，观察邻近终板的退变情况，测量椎间盘髓核区的ADC值及FA值并比较各级椎间盘之间的差异，采用Spearman等级相关检验分析ADC和FA值与Pm分级的相关性，并计算2个指标对椎间盘退变（PmⅣ～Ⅴ级）的诊断效能。结果：105例共525个腰椎椎间盘中PmⅠ～Ⅴ级分别有41、112、164、141和67个。经方差分析，PmⅠ和Ⅱ级椎间盘间ADC值、PmⅣ及Ⅴ级椎间盘间ADC值和FA值的差异无统计学意义（P〉0．05），其余各分级之间2个指标的差异有统计学意义（P〈0．05）。经ROC分析，ADC值及FA值对PmIV、V级椎间盘的诊断效能分别为0．846和0．932，两者间差异有统计学意义（P〈0．05）。Spearman秩相关分析显示，椎间盘退变Pm分级与ADC值呈负相关（rs=-0．66，P〈0．05），与FA值呈正相关（rs=0．805，P〈0．05）。结论：DTI作为定量MRI的一种特殊检查技术，其测量参数与Pfirrmann分级之间具有很好的相关性，可作为一种无创性的检查方法应用于椎间盘退变的研究。
Objective：To investigate the correlation between quantitative DTI parameters （ADC and FA） and Pfir- rmann grades of human intervertebral disc degeneration. Methods ：105 patients with lumbago were included and underwent conventional MRI and DTI. Totally 525 lumbar intervertebral discs were assessed by Pfirrmann grading system in terms of degeneration by analyzing signal intensity and morphology on routine T2 WI. The morphological changes of adjacent end- plates were observed. ADC and FA values of disc nucleus pulposuses were measured and their variances in different grades were analyzed. The ability of FA and ADC to detect lumbar disc of Pm Ⅳ ~Ⅴ grades was compared by ROC curve. The correlations between Pfirrmann grades and the two parameters were assessed by Spearman rank correlation test. Results： In all of the 525 lumbar intervertebral discs,the number of grade Ⅰ ~Ⅴ was 41,112,164,141 and 67, respectively. Statistical differences of ADC and FA values were found among degenerated discs of different grades （P〈0.05）, except ADC values between grade Ⅰ and Ⅱ ,ADC and FA values between grade Ⅳ and Ⅴ （P〉0.05）. The diagnostic efficiency of ADC and FA value for differentiating grade Ⅳ ~ Ⅴ from grade Ⅰ ~ Ⅲ were 0. 846 and 0. 932（P〈0.05） ,respectively. There was neg- ative correlation between ADC value and Pm grade （rs=- 0.66, P〈0.05）. On the contrary, disc degeneration grade was positively correlated with FA value （rs= 0. 805, P〈0.05）. Conclusion：As a special quantitatively MRI technique, its param- eters have good correlation with Pfirrmann grade,which could be used as a noninvasive method for the research of interver- tebral disc degeneration.
出处
《放射学实践》
北大核心
2016年第1期81-85,共5页
Radiologic Practice
关键词
磁共振成像
扩散张量成像
定量分析
腰椎
椎间盘病变
Magnetic resonance imaging
Diffusion tensor imaging
Quantitative study
Lumbar
Intervertebral disc diseases
