MR T2*mapping定量评价腰椎间盘退变的研究

摘要

Objective To assess the feasibility and the value of MR T2 * mapping in valuing the early degeneration of lumbar intervertebral disc quantificationally.Methods 67 patients with low back pain and 21 healthy volunteers were chosen for the study.The two groups both underwent 3.0T MR with the axial T2 WI and T2 * mapping images in 440 discs of L1-S1.We graded all intervertebral discs by Pfirrmann score,and measured the T2 * values of annulus fibrosus(AF) and nucleus pulposus(NP).Results The T2 * values of the anterior AF and the NP among different Pfirrmann grades were statistically significant (P =0.001;P =0.000,respectively).There was significant difference in T2 * values of the anterior AF at L3/L4 between patients and volunteers (P=0.043);The T2 * values of the NP at L2/L3,L3/L4,L4/L5,L5/S1 between the two groups were significant difference (P＜0.05).There was also distinct difference in T2 * values of the posterior AF at L1/L2 and L4/L5 between the two groups (P＜0.05).Conclusion The lumbar intervertebral disc degenerates from the NP to posterior AF,and mainly occurs at L4/L5.The T2 * mapping technique can provide a good basis for diagnosing in lumbar intervertebral disc degeneration.%目的 评价MR T2*mapping成像技术在定量分析腰椎间盘退变中可行性及临床应用价值.方法 对67例下腰痛患者(病例组)及21例无症状志愿者(对照组)L1～S1共440个椎间盘行3.0T MR扫描获取T2* mapping横断位图像和T2 WI图像,分别对所有椎间盘行Pfirrmann分级及前后纤维环及髓核进行T2*值测定,数据行统计学分析.结果 不同Pfirrmann等级的前纤维环和髓核的T2*值差异均有统计学意义(分别为P=0.001;P=0.000).病例组和对照组L3/L4的前纤维环T2*值有统计学差异(P=0.043),病例组和对照组L2/L3、L3/L4、L4/L5、L5/S1的髓核的T2*值有明显的统计学差异(P＜0.05),病例组和对照组L1/L2及L4/L5的后纤维环的T2*值比较有统计学差异(P＜0.05).结论 腰椎间盘退变是从髓核及后纤维环开始的且以L4/L5为主;T2*mapping成像技术能为影像学诊断腰椎间盘退变提供很好的依据.