磁共振T2 mapping序列在腰椎间盘退行性病变中的应用价值
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摘要
目的:探讨磁共振T2弛豫时间图(T2mapping)成像技术在诊断腰椎间盘退行性病变中的应用价值。方法:选取在医院就诊的97例腰椎间盘退变患者(485个腰椎间盘)纳入观察组,另选择97名同期健康体检者纳入健康组;通过3.0T磁共振成像(MRI)T2mapping成像技术对腰椎间盘进行扫描,行正中矢状位T2mapping成像,对不同MRI腰椎间盘退变的Pfirrmann分级T2mapping值(T2值)进行比较,并对不同分级腰椎间盘T2值进行相关性分析,比较两组Pfirrmann分级平均得分。结果:通过T2mapping扫描,在97例腰椎间盘退变患者的485个腰椎间盘中,I~Ⅴ级腰椎间盘个数分别为:87、142、117、98、41。通过方差分析,I~Ⅴ级间前纤维环、后纤维环及髓核T2值比较差异有统计学意义(F=9.186,F=7.013,F=11.689;P<0.05);组间两两比较,前纤维环T2值中,Ⅲ级与Ⅳ、Ⅳ级与Ⅴ级间无统计学差异,其余各组间比较差异均有统计学意义(t=7.14,5.69,P<0.05);后纤维环T2值中,Ⅰ级与Ⅱ级、Ⅳ级与Ⅴ级间无统计学差异,其余各级间比较差异均有统计学意义(t=6.18,7.09,P<0.05);髓核T2值中,Ⅳ级与Ⅴ级间无统计学差异,其余各级间均有统计学差异(t=6.34,t=5.17,t=4.82;P<0.05)。经过Pearson相关分析,髓核各分区T2值呈显著正相关(r=0.89,P<0.05),前纤维环和后纤维环T2值无明显相关(r=0.08,P>0.05)。观察组Pfirrmann分级平均得分(78.57±10.12)低于健康组,差异有统计学意义(t=10.26,P<0.05)。结论:T2mapping成像技术可作为诊断腰椎间盘退行性病变的量化依据,对于诊断腰椎间盘退行性病变具有积极意义。
Objective: To investigate the application value of imaging technique of magnetic resonance T2 mapping in the diagnosis of degenerative diseases of lumbar intervertebral disc. Methods: 97 patients with degenerative diseases of lumbar intervertebral disc(total of 485 lumbar intervertebral discs) were enrolled in observation group, and 97 health persons were enrolled in health group. Through T2 mapping imaging technique of 3.0 T MRI to implement scan for lumbar intervertebral disc, and T2 mapping imaging of middle sagittal was adopted to compare T2 of Pfirrmann classification of degenerative diseases of lumbar intervertebral disc of different MRI. And T2 value of lumbar intervertebral disc of different classification were implemented correlative analysis. And then the average score of Pfirrmann classification between two groups were further compared. Results: The results of T2 mapping scanning indicated that the amount of lumbar intervertebral disc of I-V grade were 87, 142, 117, 98 and 41, respectively, in 97 patients with degenerative diseases of lumbar intervertebral dis. The differences of T2 values of anterior fibrous ring, posterior fibrous ring and nucleus pulposus among I-V grade were significant(F=9.186, F=7.013, F=11.689, P<0.05). The results of comparison between any two means indicated that the differences of T2 value of anterior fibrous ring among any two groups, excepted III grade and IV grade, IV and V grade, were significant(t=7.14, t=5.69, P<0.05). The results also indicated that the differences of T2 value of posterior fibrous ring among any two groups, excepted I grade and II grade, IV and V grade, were significant(t=6.18, t=7.09, P<0.05). Besides, it also indicated that the differences of T2 value of nucleus pulposus among any two groups, excepted IV and V grade, were significant(t=6.34, t=5.17, t=4.82, P<0.05). The results of Pearson correlation analysis indicated that the correlation of T2 value among different subarea was significant(r=0.89, P<0.05), while the correlation of T2 value between anterior and posterior fibrous ring was no significant(r=0.08, P>0.05). In addition, the average score of Pfirrmann classification of observation group(78.57±10.12) was significantly lower than that of health group(t=10.26, P<0.05). Conclusion: T2 mapping can be used as a quantitative basis for diagnosing degenerative diseases of lumbar intervertebral disc. It has positive significance for diagnosing degenerative diseases of lumbar intervertebral disc.
Objective: To investigate the application value of imaging technique of magnetic resonance T2 mapping in the diagnosis of degenerative diseases of lumbar intervertebral disc. Methods: 97 patients with degenerative diseases of lumbar intervertebral disc(total of 485 lumbar intervertebral discs) were enrolled in observation group, and 97 health persons were enrolled in health group. Through T2 mapping imaging technique of 3.0 T MRI to implement scan for lumbar intervertebral disc, and T2 mapping imaging of middle sagittal was adopted to compare T2 of Pfirrmann classification of degenerative diseases of lumbar intervertebral disc of different MRI. And T2 value of lumbar intervertebral disc of different classification were implemented correlative analysis. And then the average score of Pfirrmann classification between two groups were further compared. Results: The results of T2 mapping scanning indicated that the amount of lumbar intervertebral disc of I-V grade were 87, 142, 117, 98 and 41, respectively, in 97 patients with degenerative diseases of lumbar intervertebral dis. The differences of T2 values of anterior fibrous ring, posterior fibrous ring and nucleus pulposus among I-V grade were significant(F=9.186, F=7.013, F=11.689, P<0.05). The results of comparison between any two means indicated that the differences of T2 value of anterior fibrous ring among any two groups, excepted III grade and IV grade, IV and V grade, were significant(t=7.14, t=5.69, P<0.05). The results also indicated that the differences of T2 value of posterior fibrous ring among any two groups, excepted I grade and II grade, IV and V grade, were significant(t=6.18, t=7.09, P<0.05). Besides, it also indicated that the differences of T2 value of nucleus pulposus among any two groups, excepted IV and V grade, were significant(t=6.34, t=5.17, t=4.82, P<0.05). The results of Pearson correlation analysis indicated that the correlation of T2 value among different subarea was significant(r=0.89, P<0.05), while the correlation of T2 value between anterior and posterior fibrous ring was no significant(r=0.08, P>0.05). In addition, the average score of Pfirrmann classification of observation group(78.57±10.12) was significantly lower than that of health group(t=10.26, P<0.05). Conclusion: T2 mapping can be used as a quantitative basis for diagnosing degenerative diseases of lumbar intervertebral disc. It has positive significance for diagnosing degenerative diseases of lumbar intervertebral disc.
引文
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[16]Zhu T,Ai T,Zhang W,et al.Segmental quantitative MR imaging analysis of diurnal variation of water content in the lumbar intervertebral discs[J].Korean J Radiol,2015,16(1):139-145.
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[20]Morgan P,Spiridonov S,Goebel R,et al.MRImaging with T2*mapping for improved acetabular cartilage assessment in FAI-a case report with arthroscopic correlation[J].Orthop Traumatol Surg Res,2014,100(8):971-973.
[21]Qasim M,Natarajan RN,An HS,et al.Initiation and progression of mechanical damage in the intervertebral disc under cyclic loading using continuum damage mechanics methodology:Afinite element study[J].J Biomech,2012,45(11):1934-1940.
[22]Buchbender C,Scherer A,Kr?pil P,et al.Cartilage quality in rheumatoid arthritis:comparison of T2*mapping,native T1 mapping,d GEMRIC,ΔR1and value of pre-contrast imaging[J].Skeletal Radiol,2012,41(6):685-692.
[2]Juras V,Bohndorf K,Heule R,et al.A comparison of multi-echo spinecho and triple-echo steadystate T2 mapping for in vivo evaluation of articular cartilage[J].Eur J Radiol,2016,26(6):1905-1912.
[3]杨泽宏,蒋伟,陈建宇,等.正常人骶髂关节骨髓T2值初步探讨[J].影像诊断与介入放射学,2013,22(5):361-363.
[4]王鹤翔,郝大鹏,徐文坚,等.3.0T MRI T2-mapping对膝关节软骨退变的评估价值[J].磁共振成像,2012,3(4):245-249.
[5]Kwon YJ.A minimally invasive rabbit model of progressive and reproducible disc degeneration confirmed by radiology,gene expression,and histology[J].J Korean Neurosurg Soc,2014,53(5):323-330.
[6]孟凡星,卢再鸣,于兵,等.磁共振T2 mapping成像在乳腺病变良恶性鉴别诊断中的应用[J].中国临床医学影像杂志,2013,24(5):317-320.
[7]Nagy SA,Juhasz I,Komaromy H,et al.A statistical model for intervertebral disc degeneration:determination of the optimal T2 cut-off values[J].Clin Neuroradiol,2014,24(4):355-363.
[8]Yu A,Heilmeier U,Kretzschmar M,et al.Racial differences in biochemical knee cartilage composition between African-American and Caucasian-American women with 3T MR-based T2 relaxation time measurementsdata from the Osteoarthritis Initiative[J].Osteoarthritis Cartilage,2015,23(9):1595-1604.
[9]Zhen Tao,Hu Dacheng,Chen Wenhui.The value of T2 mapping sequence in early diagnosis of ankylosing spondylitis[J].Zhejiang Clinical Medical Journal,2015,17(3):344-348.
[10]刘珍珍,陈建宇,蔡兆熙,等.腰椎间盘退变MRI:T1rho值与Pfirrmann分级及T2值的相关性[J].中国医学影像技术,2014,30(2):260-264.
[11]Zhu JY,Wang XM.The study of correlation between ageandanatomical segment in healthy lumbar interverbral discs by diffusion tensor imaging[J].Chin J Magn Reson Imaging,2015,3(7):518-523.
[12]黄耀渠,赵晓梅,伍琼惠,等.MR T2弛豫时间评估颈椎间盘退变的初步研究[J].磁共振成像,2015,6(11):843-847.
[13]Filardo G,Vannini F,Marcacci M,et al.Matrixassisted autologous chondrocyte transplantation for cartilage regeneration in osteoarthritic knees:results and failures at midterm followup[J].Am J Sports Med,2013,41(1):95-100.
[14]王之平,吴伟,廖国政,等.磁共振T2-mapping成像在早期膝关节骨性关节炎诊断中的应用价值[J].中国医学计算机成像杂志,2014,20(1):46-49.
[15]Tokgoz N,Akdeniz M,Ucar M,et al.Is quantitative magnetic resonance imaging valuable in the assessment of trabecular bone structure in osteoporosis[J].Eklem Hastalik Cerrahisi,2013,24(1):2-6.
[16]Zhu T,Ai T,Zhang W,et al.Segmental quantitative MR imaging analysis of diurnal variation of water content in the lumbar intervertebral discs[J].Korean J Radiol,2015,16(1):139-145.
[17]Xu Qilan,Hong Guobin,Liu Qiang,et al.Preliminary study of T2 mapping imaging for the sacroiliac joint cartilage imaging in young healthy volunteers[J].Journal of Medical Imaging,2015,25(7):1269-1272.
[18]Antoniou J,Epure LM,Michalek AJ,et al.Analysis of quantitative magnetic resonance imaging and biomechanical parameters on human discs with different grades of degeneration[J].J Magn Reson Imaging,2013,38(6):1402-1414.
[19]郭智萍,张旭静,朱瑾,等.3.0T磁共振T2 mapping成像诊断腰椎间盘退变[J].中国医学影像技术,2013,29(11):1849-1852.
[20]Morgan P,Spiridonov S,Goebel R,et al.MRImaging with T2*mapping for improved acetabular cartilage assessment in FAI-a case report with arthroscopic correlation[J].Orthop Traumatol Surg Res,2014,100(8):971-973.
[21]Qasim M,Natarajan RN,An HS,et al.Initiation and progression of mechanical damage in the intervertebral disc under cyclic loading using continuum damage mechanics methodology:Afinite element study[J].J Biomech,2012,45(11):1934-1940.
[22]Buchbender C,Scherer A,Kr?pil P,et al.Cartilage quality in rheumatoid arthritis:comparison of T2*mapping,native T1 mapping,d GEMRIC,ΔR1and value of pre-contrast imaging[J].Skeletal Radiol,2012,41(6):685-692.