3.0 T磁共振定量T_2及T_2~* mapping技术在颈椎间盘退变中的应用
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摘要
目的对比研究T_2及T_2~* mapping技术在颈椎间盘退变研究中的价值。方法回顾性分析因反复颈部不适行颈椎间盘3.0 T MRI检查者35例,扫描序列为矢状位T_1WI、T_2WI、T_2WI-脂肪抑制像、T_2 mapping、T_2~* mapping及轴位T_2WI,共获得颈椎间盘175个。所有椎间盘利用Pfirrmann分级法进行分级,Ⅰ级14个,Ⅱ级46个,Ⅲ级101个,Ⅳ级14个。T_2及T_2~* mapping原始图像经工作站处理后分别获取髓核、前纤维环及后纤维环弛豫时间。所得数据经SPSS 13.0软件包进行统计学处理,P<0.05为差异有统计学意义。对两种技术所得数据进行线性回归分析,得出相关系数,了解其相关性。对两种技术所得相同区域弛豫时间值与Pfirrmann分级进行Spearman相关分析。结果髓核T_2值各级间差异均有统计学意义,T_2~*值除Ⅲ/Ⅳ级间无显著性差异外,余各级间差异有统计学意义,前后纤维环两种技术所得数据各级间差异均无统计学意义。PfirrmannⅠ级中,前后纤维环间T_2值差异无统计学意义,余区域间差异有统计学意义;各区域T_2~*值差异均有统计学意义。PfirrmannⅡ级中,两种技术所得前后纤维环弛豫时间值间差异无统计学意义,余各区域差异有统计学意义。PfirrmannⅢ级中,各区域T_2值差异均有统计学意义;T_2~*值前后纤维环间差异无统计学意义,余各区域间差异有统计学意义。PfirrmannⅣ级中,髓核与前纤维环间T_2值差异有统计学意义,余各区域间差异无统计学意义;前后纤维环间T_2~*值差异无统计学意义,余各区域间差异有统计学意义。两种技术在髓核、前纤维环、后纤维环所得数据相关系数分别为0.64、0.55、0.51。髓核区T_2、T_2~*值及前纤维环T_2值与Pfirrmann分级呈负相关(r=-0.68、-0.50、-0.18,P<0.05)。结论 T_2及T_2~* mapping技术均可对颈椎间盘退变程度进行初步定量评估,且所得结果具有较高的一致性。
Objective To explore the potential clinical application of T_2 and T_2~* mapping technique in the cervical intervertebral disc degeneration. Methods 35 subjects with repeated neck pain who underwent cervical intervertebral disc MRI scanning were selected for study. MR sequence contained sagittal T_1WI,T_2WI,T_2WI-FS,T_2 mapping,T_2~* mapping and axial T_2WI,175 cervical discs were selected,all discs were classified according to the Pfirrmann score,14 discs in grade Ⅰ,46 in grade Ⅱ,101 in grade Ⅲ,14 in grade Ⅳ. All the cases were examined at a clinical 3.0 T MR imaging unit. All the primitive data were sent to VB10 B workstation for post-processing,thus T_2 and T_2~* times of nucleus pulposus(NP),anterior annulus fibrosus(AAF) and posterior annulus fibrosus(PAF) of each disc were obtained respectively. All data were calculated by SPSS 13.0 software package,the statistically significant difference was set at P<0.05.Linear Regression analysis was performed to detect the correlation between the two techniques.The correlation between T_2,T_2~* values and Pfirrmann grades of the IVDs was evaluated by Spearman analysis. Results In the nucleus pulposus,statistically significant differences(P<0.05) existed at different grades for T_2 values,significant differences were found at different grades for T_2~* values except between grade Ⅲ and grade Ⅳ.Significant differences were not found between AAF and PAF for T_2 and T_2~* values at different grades.For gradeⅠ,statistically significant differences(P<0.05) existed at different regions for T_2 values except between AAF and PAF,significant differences were found at different regions for T_2~* values.For gradeⅡ,statistically significant differences(P<0.05) existed at different regions for T_2 and T_2~* values except between AAF and PAF.For grade Ⅲ,statistically significant differences(P<0.05) existed at different regions for T_2 values,significant differences were found at different regions for T_2~* values except between AAF and PAF.For grade Ⅳ,statistically significant differences(P<0.05) existed between nucleus pulposus and AAF for T_2 values,significant differences were found at different regions for T_2~* values except between AAF and PAF.Correlation coefficient between T_2 and T_2~* values in the nucleus pulposus,AAF and PAF obtained by T_2 and T_2~* mapping based on linear regression analysis were 0.64,0.55 and 0.51 respectively.Negative correlation with the Pfirrmann score could be found in nucleus pulposus for T_2 and T_2~* values,in AAF for T_2 values(r=-0.68,-0.50,-0.18,P<0.05). Conclusion T_2 and T_2~* mapping could be used for quantitative evaluation the degree of the cervical IVD degeneration preliminarily,and the results of both methodologies have a high consistency.
Objective To explore the potential clinical application of T_2 and T_2~* mapping technique in the cervical intervertebral disc degeneration. Methods 35 subjects with repeated neck pain who underwent cervical intervertebral disc MRI scanning were selected for study. MR sequence contained sagittal T_1WI,T_2WI,T_2WI-FS,T_2 mapping,T_2~* mapping and axial T_2WI,175 cervical discs were selected,all discs were classified according to the Pfirrmann score,14 discs in grade Ⅰ,46 in grade Ⅱ,101 in grade Ⅲ,14 in grade Ⅳ. All the cases were examined at a clinical 3.0 T MR imaging unit. All the primitive data were sent to VB10 B workstation for post-processing,thus T_2 and T_2~* times of nucleus pulposus(NP),anterior annulus fibrosus(AAF) and posterior annulus fibrosus(PAF) of each disc were obtained respectively. All data were calculated by SPSS 13.0 software package,the statistically significant difference was set at P<0.05.Linear Regression analysis was performed to detect the correlation between the two techniques.The correlation between T_2,T_2~* values and Pfirrmann grades of the IVDs was evaluated by Spearman analysis. Results In the nucleus pulposus,statistically significant differences(P<0.05) existed at different grades for T_2 values,significant differences were found at different grades for T_2~* values except between grade Ⅲ and grade Ⅳ.Significant differences were not found between AAF and PAF for T_2 and T_2~* values at different grades.For gradeⅠ,statistically significant differences(P<0.05) existed at different regions for T_2 values except between AAF and PAF,significant differences were found at different regions for T_2~* values.For gradeⅡ,statistically significant differences(P<0.05) existed at different regions for T_2 and T_2~* values except between AAF and PAF.For grade Ⅲ,statistically significant differences(P<0.05) existed at different regions for T_2 values,significant differences were found at different regions for T_2~* values except between AAF and PAF.For grade Ⅳ,statistically significant differences(P<0.05) existed between nucleus pulposus and AAF for T_2 values,significant differences were found at different regions for T_2~* values except between AAF and PAF.Correlation coefficient between T_2 and T_2~* values in the nucleus pulposus,AAF and PAF obtained by T_2 and T_2~* mapping based on linear regression analysis were 0.64,0.55 and 0.51 respectively.Negative correlation with the Pfirrmann score could be found in nucleus pulposus for T_2 and T_2~* values,in AAF for T_2 values(r=-0.68,-0.50,-0.18,P<0.05). Conclusion T_2 and T_2~* mapping could be used for quantitative evaluation the degree of the cervical IVD degeneration preliminarily,and the results of both methodologies have a high consistency.
引文
1 Williams FM,Sambrook PN.Neck and back pain and intervertebral disc degeneration:role of occupational factors[J].Best Pract Res Clin Rheumatol,2011,25:69-79.
2 Marinelli NL,Haughton VM,Munoz A,et al.T2 relaxation times of intervertebral disc tissue correlated with water content and proteoglycan content[J].Spine (Phila Pa 1976),2009,34:520-524.
3 Hoppe S,Quirbach S,Mamisch TC,et al.Axial T2* mapping in intervertebral discs:a new technique for assessment of intervertebral disc degeneration[J].Eur Radiol,2012,22:2013-2019.
4 Horner HA,Urban JP.Effect of nutrient supply on the viability of cells from the nucleus pulposus of the intervertebral disc[J].Spine,2001,26:2543-2549.
5 Resnick D,Niwayama G.Degenerative disc disease of the spine:Diagnosis of bone and joint disorders[M].4th ed.Philadelphia:WB Saunders,2002:1372-1465.
6 Pfirrmann CW,Metzdorf A,Zanetti M,et al.Magnetic resonance classification of lumbar intervertebral disc degeneration[J].Spine (Phila Pa 1976),2001,26:1873-1878.
7 李建文,舒建军,王新辉,等.DTI及T2mapping对腰椎间盘退变的诊断价值[J].实用放射学杂志,2016,32:1919-1922.
8 刘珍珍,陈建宇,蔡兆熙,等.腰椎间盘退变MRI:T1rho与Pfirrmann分级及T2值的相关性[J].中国医学影像技术,2014,30:260-264.
9 高峰,张宗军,唐文伟,等.膝关节软骨磁共振T2及T2 star 弛豫时间图成像的初步研究[J].临床放射学杂志,2013,32:1305-1310.
10 Yamamoto S,Watanabe A,Nakamura J,et al.Quantitative T2 mapping of femoral head cartilage in systemic lupus erythematosus patients with noncollapsed osteonecrosis of the femoral head associated with corticosteroid therapy[J].J Magn Reson Imaging,2011,34:1151-1158.
11 Souza RB,Baum T,Wu S,et al.Effects of unloading on knee articular cartilage T1rho and T2 magnetic resonance imaging relaxation times:a case series[J].J Orthop Sports Phys Ther,2012,42:511-520.
12 王建伟,许晓泉,王德杭,等.T2 mapping技术在腰椎间盘退变评估中的应用价值[J].中国临床医学影像杂志,2015,26:355-358.
13 Detiger SE,Holewijn RM,Hoogendoorn RJ,et al.MRI T2* mapping correlates with biochemistry and histology in intervertebral disc degeneration in a large animal model[J].Eur Spine J,2015,24:1935-1943.
14 Stelzeneder D,Welsch GH,Kovacs BK,et al.Quantitative T2 evaluation at 3.0T compared to morphological grading of the lumbar intervertebral disc:a standardized evaluation approach in patients with low back pain[J].Eur J Radiol,2012,81:324-330.
15 Trattnig S,Stelzeneder D,Goed S,et al.Lumbar intervertebral disc abnormalities:comparison of quantitative T2 mapping with conventional MR at 3.0 T[J].Eur Radiol,2010,20:2715-2722.
16 Welsch GH,Trattnig S,Paternostro-Sluga T,et al.Parametric T2 and T2* mapping techniques to visualize intervertebral disc degeneration in patients with low back pain:initial results on the clinical use of 3.0 Tesla MRI[J].Skeletal Radiol,2011,40:543-551.
17 Scott JE,Bosworth TR,Cribb AM,et al.The chemical morphology of age-related changes in human intervertebral disc glycosaminoglycans from cervical,thoracic and lumbar nucleus pulposus and annulus fibrosus[J].J Anat,1994,184:73-82.
18 龚静山,凌人男,周阳泱,等.采用3.0 T MRI T2和T2* mapping评价下腰痛患者腰椎间盘退变[J].中国CT和MRI杂志,2016,14:113-116.
2 Marinelli NL,Haughton VM,Munoz A,et al.T2 relaxation times of intervertebral disc tissue correlated with water content and proteoglycan content[J].Spine (Phila Pa 1976),2009,34:520-524.
3 Hoppe S,Quirbach S,Mamisch TC,et al.Axial T2* mapping in intervertebral discs:a new technique for assessment of intervertebral disc degeneration[J].Eur Radiol,2012,22:2013-2019.
4 Horner HA,Urban JP.Effect of nutrient supply on the viability of cells from the nucleus pulposus of the intervertebral disc[J].Spine,2001,26:2543-2549.
5 Resnick D,Niwayama G.Degenerative disc disease of the spine:Diagnosis of bone and joint disorders[M].4th ed.Philadelphia:WB Saunders,2002:1372-1465.
6 Pfirrmann CW,Metzdorf A,Zanetti M,et al.Magnetic resonance classification of lumbar intervertebral disc degeneration[J].Spine (Phila Pa 1976),2001,26:1873-1878.
7 李建文,舒建军,王新辉,等.DTI及T2mapping对腰椎间盘退变的诊断价值[J].实用放射学杂志,2016,32:1919-1922.
8 刘珍珍,陈建宇,蔡兆熙,等.腰椎间盘退变MRI:T1rho与Pfirrmann分级及T2值的相关性[J].中国医学影像技术,2014,30:260-264.
9 高峰,张宗军,唐文伟,等.膝关节软骨磁共振T2及T2 star 弛豫时间图成像的初步研究[J].临床放射学杂志,2013,32:1305-1310.
10 Yamamoto S,Watanabe A,Nakamura J,et al.Quantitative T2 mapping of femoral head cartilage in systemic lupus erythematosus patients with noncollapsed osteonecrosis of the femoral head associated with corticosteroid therapy[J].J Magn Reson Imaging,2011,34:1151-1158.
11 Souza RB,Baum T,Wu S,et al.Effects of unloading on knee articular cartilage T1rho and T2 magnetic resonance imaging relaxation times:a case series[J].J Orthop Sports Phys Ther,2012,42:511-520.
12 王建伟,许晓泉,王德杭,等.T2 mapping技术在腰椎间盘退变评估中的应用价值[J].中国临床医学影像杂志,2015,26:355-358.
13 Detiger SE,Holewijn RM,Hoogendoorn RJ,et al.MRI T2* mapping correlates with biochemistry and histology in intervertebral disc degeneration in a large animal model[J].Eur Spine J,2015,24:1935-1943.
14 Stelzeneder D,Welsch GH,Kovacs BK,et al.Quantitative T2 evaluation at 3.0T compared to morphological grading of the lumbar intervertebral disc:a standardized evaluation approach in patients with low back pain[J].Eur J Radiol,2012,81:324-330.
15 Trattnig S,Stelzeneder D,Goed S,et al.Lumbar intervertebral disc abnormalities:comparison of quantitative T2 mapping with conventional MR at 3.0 T[J].Eur Radiol,2010,20:2715-2722.
16 Welsch GH,Trattnig S,Paternostro-Sluga T,et al.Parametric T2 and T2* mapping techniques to visualize intervertebral disc degeneration in patients with low back pain:initial results on the clinical use of 3.0 Tesla MRI[J].Skeletal Radiol,2011,40:543-551.
17 Scott JE,Bosworth TR,Cribb AM,et al.The chemical morphology of age-related changes in human intervertebral disc glycosaminoglycans from cervical,thoracic and lumbar nucleus pulposus and annulus fibrosus[J].J Anat,1994,184:73-82.
18 龚静山,凌人男,周阳泱,等.采用3.0 T MRI T2和T2* mapping评价下腰痛患者腰椎间盘退变[J].中国CT和MRI杂志,2016,14:113-116.