磁共振T_2-mapping技术评估腰椎间盘及椎小关节运动负荷的研究
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摘要
目的:采用磁共振T_2-mapping技术测量腰椎间盘和椎小关节生理负荷后其基质的含水量变化,分析腰椎间盘和椎小关节之间的相互作用。方法:选取28名健康年轻志愿者,男性和女性各14名,在生理负荷(屈曲、伸展和旋转)前后进行磁共振成像(MRI)扫描。将L_(1/2)～L_5/S_1的每个椎间盘的中心层面,在髓核、前纤维环、后纤维环和双侧小关节测量T_2弛豫时间值。结果:腰椎运动后L_(1/2)～L_5/S_1椎间盘髓核T_2弛豫时间值显著下降,每个腰椎间盘T_2弛豫时间值差异均有统计学意义(t=4.36,t=4.65,t=5.64,t=4.39,t=4.87;P<0.05);前纤维环中的T_2弛豫时间值下降无统计学意义(t=1.42,t=1.38,t=0.96,t=1.35,t=1.25;P>0.05);后纤维环中的T2弛豫时间值仅在L_4/_5时显著增加,其差异有统计学意义(t=4.86,P<0.05),其余椎间盘均无统计学意义(t=1.37,t=0.63,t=1.25,t=1.58;P>0.05);在双侧小关节运动后T_2弛豫时间值显著下降,其差异有统计学意义[右侧(t=4.52,t=4.68,t=4.87,t=5.39,t=5.26;P<0.05);左侧(t=4.67,t=4.23,t=4.73,t=5.28,t=5.16;P<0.05)]。结论:椎间盘中的髓核基质和椎小关节中的软骨以相互作用的方式维持着重要的作用,这种相互作用的认知作为承载结构可以为临床干预、康复训练及物理治疗提供重要信息。
Objective:To analyze the interaction between lumbar intervertebral disc and facet joint through measured the change of water content of matrix by using T_2 mapping technique of magnetic resonance(MR)after they implemented physiological workload.Methods:Twenty-eight asymptomatic young volunteers(14 males and14 females)were selected,and all of them underwent MRI scans before and after they implemented physiological workload(flexion,extension and rotation).The T_2 relaxation time values were measured at the nucleus pulposus,anterior fibrous annulus,posterior fibrous annulus and bilateral facet joints of the central level of each disc of L_(1/2)-L_5S_1.Results:The T_2 relaxation time in nucleus pulposus of L_(1/2)-L_5 S_1 intervertebral disc post exercise of lumbar vertebra was significantly decreased,and difference of each T_2 relaxation time between pre and post exercise was significant(t=4.36,t=4.65,t=5.64,t=4.39,t=4.87,P<0.05),respectively.The decreases of T_2 relaxation time in anterior fibrous annulus were no significant(t=1.42,t=1.38,t=0.96,t=1.35,t=1.25,P>0.05),respectively.And the T_2 relaxation time in the posterior fibrous annulus only increased significantly at L_4/_5(t=4.86,P<0.05),and the differences of other intervertebral discs were no significant(t=1.37,t=0.63,t=1.25,t=1.58,P>0.05).The T_2 relaxation time decreased significantly after the bilateral facet joint implemented movement(right:t=4.52,t=4.68,t=4.87,t=5.39,t=5.26,left:t=4.67,t=4.23,t=4.73,t=5.28,t=5.16,P<0.05).Conclusion:The matrix of nucleus pulposus in intervertebral disc and cartilage in facet joint maintain important role in an interactive manner.As a carrier structure,the interactive cognition may provide important information for clinical interventions,rehabilitation training and physiotherapy.
Objective:To analyze the interaction between lumbar intervertebral disc and facet joint through measured the change of water content of matrix by using T_2 mapping technique of magnetic resonance(MR)after they implemented physiological workload.Methods:Twenty-eight asymptomatic young volunteers(14 males and14 females)were selected,and all of them underwent MRI scans before and after they implemented physiological workload(flexion,extension and rotation).The T_2 relaxation time values were measured at the nucleus pulposus,anterior fibrous annulus,posterior fibrous annulus and bilateral facet joints of the central level of each disc of L_(1/2)-L_5S_1.Results:The T_2 relaxation time in nucleus pulposus of L_(1/2)-L_5 S_1 intervertebral disc post exercise of lumbar vertebra was significantly decreased,and difference of each T_2 relaxation time between pre and post exercise was significant(t=4.36,t=4.65,t=5.64,t=4.39,t=4.87,P<0.05),respectively.The decreases of T_2 relaxation time in anterior fibrous annulus were no significant(t=1.42,t=1.38,t=0.96,t=1.35,t=1.25,P>0.05),respectively.And the T_2 relaxation time in the posterior fibrous annulus only increased significantly at L_4/_5(t=4.86,P<0.05),and the differences of other intervertebral discs were no significant(t=1.37,t=0.63,t=1.25,t=1.58,P>0.05).The T_2 relaxation time decreased significantly after the bilateral facet joint implemented movement(right:t=4.52,t=4.68,t=4.87,t=5.39,t=5.26,left:t=4.67,t=4.23,t=4.73,t=5.28,t=5.16,P<0.05).Conclusion:The matrix of nucleus pulposus in intervertebral disc and cartilage in facet joint maintain important role in an interactive manner.As a carrier structure,the interactive cognition may provide important information for clinical interventions,rehabilitation training and physiotherapy.
引文
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[2]Silver FH,Bradica G,Tria A.Relationship among biomechanical,biochemical,and cellular changes associated with osteoarthritis[J].Crit Rev Biomed Eng,2001,29(4):373-391.
[3]Leddy HA,Guilak F.Site-specific effects of compression on macromolecular diffusion in articular cartilage[J].Biophys J,2008,95(10):4890-4895.
[4]Eckstein F,Lemberger B,Stammberger T,et al.Patellar cartilage deformation in vivo after static versus dynamic loading[J].J Biomech,2000,33(7):819-825.
[5]Eckstein F,Tieschky M,Faber S,et al.Functional analysis of articular cartilage deformation,recovery,and fluid flow following dynamic exercise in vivo[J].Anat Embryol(Berl),1999,200(4):419-424.
[6]Eckstein F,Tieschky M,Faber S,et al.Effect of physical exercise on cartilage volume and thickness in vivo:MR imaging study[J].Radiology,1998,207(1):243-248.
[7]Yamabe D,Murakami H,Chokan K,et al.Evaluation of water content in lumbar intervertebral discs and facet joints before and after physiological loading using t2 mapping MRI[J].Spine(Phila Pa1976),2017,42(24):E1423-1428.
[8]Hu J,Zhang Y,Duan C,et al.Feasibility study for evaluating early lumbar facet joint degeneration using axial T1ρ,T2,and T2*mapping in cartilage[J].J Magn Reson Imaging,2017,46(2):468-475.
[9]Luoma K,Vehmas T,Riihim?ki H,et al.Disc height and signal intensity of the nucleus pulposus on magnetic resonance imaging as indicators of lumbar disc degeneration[J].Spine,2001,26(6):680-686.
[10]Ellingson AM,Nagel TM,Polly DW,et al.Quantitative T2*(T2 star)relaxation times predict site specific proteoglycan content and residual mechanics of the intervertebral disc throughout degeneration[J].J Orthop Res,2014,32(8):1083-1089.
[11]Weishaupt D,Zanetti M,Hodler J,et al.MR imaging of the lumbar spine:prevalence of intervertebral disk extrusion and sequestration,nerve root compression,end plate abnormalities,and osteoarthritis of the facet joints in asymptomatic volunteers[J].Radiology,1998,209(3):661-666.
[12]Takatalo J,Karppinen J,Niinim?ki J,et al.Prevalence of degenerative imaging findings in lumbar magnetic resonance imaging among young adults[J].Spine,2009,34(16):1716-1721.
[13]Yang KH,King AI.Mechanism of facet load transmission as a hypothesis for low-back pain[J].Spine(Phila Pa 1976),1984,9(6):557-565.
[14]Ogon I,Takebayashi T,Takashima H,et al.Analysis of chronic low back pain with magnetic resonance imaging T2 mapping of lumbar intervertebral disc[J].J Orthop Sci,2015,20(2):295-301.