腰椎间盘的扩散张量成像观测及临床应用

doi:10.13418/j.issn.1001-165x.2019.05.007

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (5): 512-516.doi: 10.13418/j.issn.1001-165x.2019.05.007

腰椎间盘的扩散张量成像观测及临床应用

李培¹，　侯新新¹，　徐新朝²，　付升旗²

1.新乡医学院第三附属医院放射科；　2.新乡医学院解剖学教研室，河南新乡 453003

收稿日期:2018-08-16 出版日期:2019-09-25 发布日期:2019-09-25
通讯作者: 付升旗，教授，硕士生导师，E-mail: fushengqihappy@126.com
作者简介:李培（1977-），女，河南新乡人，副主任医师，本科学士，主要从事脊柱、四肢的断层影像及临床应用，Tel:（0373）3029628

Diffusion tensor imaging observation and clinical application of the lumbar intervertebral disc

LI Pei¹, HOU Xin-xin¹, XU Xin-chao², FU Sheng-qi²

1. Department of Radiology, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003, Henan Province, China; 2. Department of Anatomy, Xinxiang Medical University, Xinxiang 453003, Henan Province, China

Received:2018-08-16 Online:2019-09-25 Published:2019-09-25

摘要/Abstract

摘要： 目的　为腰椎间盘退变导致的腰腿痛等病症的临床诊断提供影像学依据。方法　选取脊柱腰段扩散张量成像（DTI）扫描检查正常者200例和腰椎间盘退变者100例，在工作站划分腰椎间盘和腰椎间盘退变的感兴趣区，测量感兴趣区的表观扩散系数（ADC）和各向异性分数（FA），比较不同解剖部位、年龄组腰椎间盘和不同Pfirrmann分级腰椎间盘退变的FA、ADC值。结果　不同解剖部位腰椎间盘的FA值和ADC值均有统计学差异（P<0.05），L1~2、L2~3、L3~4椎间盘的FA值逐渐降低，L4~5、L5~S1椎间盘的FA值则逐渐增高；L1~2、L2~3、L3~4椎间盘的ADC值逐渐增高，L3~4、L4~5、L5~S1椎间盘的ADC值则无明显变化。不同年龄组腰椎间盘的FA值无统计学差异（P>0.05），ADC值有统计学差异（P<0.05），随着年龄增长ADC值逐渐降低。不同Pfirrmann分级腰椎间盘退变的FA值和ADC值均有统计学差异（P<0.05），随着Pfirrmann分级增高，FA值逐渐增高，ADC值逐渐降低。结论　解剖部位、年龄均影响腰椎间盘的ADC值，DTI的FA值和ADC值可以定量评估腰椎间盘及其退变程度，为早期腰椎间盘退变的临床诊断提供影像学依据。

关键词: 腰椎间盘, 　扩散张量成像, 　腰椎间盘退变, 　MRI

Abstract: Objective　 To provide imaging basis for clinical diagnosis of the waist and leg pain caused by the lumbar intervertebral disc degeneration.　Methods　There were 200 persons with normal lumbar spine and 100 cases with lumbar intervertebral disc degeneration selected and scanned by diffusion tensor imaging (DTI). The region of interest of the lumbar intervertebral disc and the lumbar intervertebral disc degeneration was selected at workstation, and the apparent diffusion coefficient (ADC) value and the fractional anisotropy (FA) value of the region of interest were measured. The FA value and ADC value of lumbar intervertebral disc in different anatomic sites, age groups and different Pfirrmann grades of the lumbar intervertebral disc degeneration were compared.　Results　The FA value and ADC value of lumbar intervertebral discs in different anatomic sites had significant difference (P<0.05). The FA values of L1~2, L2~3 and L3~4 intervertebral discs were gradually decreased, and the FA values of L4~5 and L5~S1 intervertebral discs were gradually increased. The ADC values of L1~2, L2~3 and L3~4 intervertebral discs were gradually increased, and the ADC values of L3~4、L4~5、L5~S1 intervertebral discs were not changed significantly. There was no statistical difference in FA values among different age groups (P>0.05). There was statistical differences in ADC values (P<0.05), and the ADC values were gradually decreased with the ages. There were statistical differences in FA values and ADC values in the different Pfirrmann grades of lumbar intervertebral disc degeneration, and with the Pfirrmann gradation increasing, the FA values were gradually increased, and the ADC values were gradually decreased. Conclusions The ADC value of the lumbar intervertebral disc can be influenced by the different anatomic sites and age. The FA value and ADC value of DTI can quantitatively evaluate the degree of lumbar intervertebral disc degeneration, and provide imaging basis for clinical diagnosis of early lumbar intervertebral disc degeneration.

Key words: Lumbar intervertebral disc, 　Diffusion tensor imaging, 　Lumbar intervertebral disc degeneration, , , , MRI

中图分类号:

李培, 侯新新, 徐新朝, 付升旗. 腰椎间盘的扩散张量成像观测及临床应用[J]. 中国临床解剖学杂志, 2019, 37(5): 512-516.

LI Pei, HOU Xin-xin, XU Xin-chao, FU Sheng-qi. Diffusion tensor imaging observation and clinical application of the lumbar intervertebral disc[J]. Chinese Journal of Clinical Anatomy, 2019, 37(5): 512-516.

参考文献 16

[1]	贺露娇, 祝巧云, 贺发良, 等. DTI在诊断腰椎间盘及神经根受压中的应用[J]. 实用放射学杂志, 2017, 33(3): 471-473.
[2]	赖志权. 弥散张量成像在腰椎间盘早期退化研究中的应用价值[J]. 临床医学工程, 2017, 24(4): 440-442.
[3]	Pfirrmann CW, Metzdorf A, Zanetti M, et a1. Magnetic resonance classification of lumbar intervertebral disc degeneration[J]. Spine, 2001, 26(17): 1873-1878.
[4]	吴有森, 包海华．磁共振扩散张量成像技术的研究[J]. 青海医药杂志, 2011, 41(11): 75-77.
[5]	李钦海, 陈光玉．DWI和DTI对腰椎间盘早期退变的诊断价值[J]. 中国实用医药, 2016, 11(19): 74-75.
[6]	邓绍强, 杜勇, 杨汉丰, 等．弥散加权ADC值定量评价髓核蛋白多糖含量的研究[J]. 中国临床医学影像杂志, 2013, 24(9): 650-653.
[7]	Antoniou J, Epure LM, Michalek AJ, et al. Analysis of quantitative magnetic resonance imaging and biomechanical parameteters on human discs with different grades of degeneration[J]. J Magn Reson Imaging, 2013, 38(6): 1402-1414.
[8]	Kealey SM, Aho T, Delong D, et a1. Assessment of apparent diffusion coefficient in normal and degenerated intervertebral lumbar disks: initial experience[J]. Radiology, 2005, 235(6): 569-574.
[9]	Kerttula LI, Jauhiainen JP, Tervonen O, et a1. Apparent diffusion coefficient in thoracolumbar intervertabral discs of healthy young volunteers[J]. J Mage Reson Imaging, 2000, 12(2): 255-260.
[10]	沈思, 王昊, 汪飞, 等．DWI和DTI对腰椎间盘早期退变的诊断价值[J]. 暨南大学学报学报(医学版), 2012, 33(4): 409-413.
[11]	俎金燕, 王晨光, 贾宁阳, 等．腰椎间盘退行变的磁共振弥散加权成像研究[J]. 实用放射学杂志, 2013, 29(4): 611-614.
[12]	郭家川, 杨汉丰, 杜勇, 等．ADC值在腰椎间盘退行性变诊断中价值的初步研究[J]. 临床放射学杂志, 2011, 30(2): 239-242.
[13]	龙厚清, 林尔坚, 胡勇, 等．腰椎间盘MR扩散张量成像及其定量分析[J]. 中国临床解剖学杂志, 2012, 30(1): 44-47.
[14]	梁文彬, 胡卫东, 娄明武．椎间盘纤维环磁共振弥散张量成像及量化分析[J]. 现代医用影像学, 2014, 23(3): 199-201.
[15]	张娅, 陈建宇, 蒋新华, 等．MRI表观弥散系数与腰椎间盘退变分级的相关性[J]. 中国医学影像技术, 2011, 27(6): 1264-1267.
[16]	Zhong X, Qiu S. Effect of exercise load on apparent diffusion coefficient and fractional anisotropy of normal lumbar intervertebraldiscs in diffusion tensor imaging[J]. Nan Fang Yi Ke Da Xue Bao, 2015, 35 (6): 812-815.

腰椎间盘的扩散张量成像观测及临床应用

Diffusion tensor imaging observation and clinical application of the lumbar intervertebral disc

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