磁共振T2-mapping检查对颈椎间盘退行性变的诊断价值

摘要

目的 探讨磁共振T2-mapping检查评估颈椎间盘退行性变的价值.方法 选取石家庄市第二医院2016年1—11月健康受试者42例行常规颈椎MRI及T2-mapping扫描,对受试者颈椎间盘进行Pfirrmann分级,分析T2值与Pfirrmann分级间的相关性,并比较不同年龄、解剖节段髓核的T2弛豫时间值.结果 42例健康受试者共210个颈椎间盘,Pfirrmann分级资料Ⅰ、Ⅱ、Ⅲ、Ⅳ、V级例数分别为20、85、98、7、0例.Spearman相关分析显示髓核平均T2值与Pfirrmann分级存在负相关性(r=-0.67,P<0.01),髓核平均T2值随着Pfirrmann分级的升高而逐渐下降;不同Pfirrmann分级间髓核平均T2值比较差异有统计学意义(P<0.01);ROC曲线图显示,T2值在诊断Ⅰ级和Ⅱ级、Ⅱ级和Ⅲ级、Ⅲ级和Ⅳ级颈椎间盘曲线下面积分别为0.78、0.80及0.79(P<0.05);在18～30岁年龄阶段中,不同颈椎间盘节段中T2值比较差异有统计学意义(P<0.01);31～40岁在不同颈椎间盘节段中T2值低于18～30岁(P<0.01).结论 磁共振T2-mapping检查可对颈椎间盘退变及其年龄、解剖节段相关变化评估价值较高.%Objective To investigate value of magnetic resonance T2-mapping examination in evaluation of de-generation of cervical intervertebral disc. Methods A total of 42 healthy people underwent routine cervical magnetic res-onance imaging (MRI) and T2-mapping scan from January to November 2016, and Pfirrmann classification for cervical intervertebral disk was performed for the people, and then correlation between T2 value and Pfirrmann classification was analyzed. Values of T2 relaxation times of nucleus pulposus at different ages and anatomic sections were compared. Re-sults There were 210 cervical intervertebral discs in the 42 healthy people. Numbers of grade I, II, III, IV and V Pfir-rmann classification were 20, 85, 98, 7 and 0 respectively. Spearman correlation analysis showed that there was a nega-tive correlation between the mean T2 value of nucleus pulposus with Pfirrmann classification (r= -0. 67, P<0. 01);the mean T2 value of nucleus pulposus was decreased gradually with increasing Pfirrmann grading;there were significant differences in mean T2 values of nucleus pulposus among different Pfirrmann grading groups (P<0. 01). Receiver oper-ating curve ( ROC) graph shows that T2 values of area under curve in diagnosis of grade I and II, II and III, III and IV intervertebral disks, were 0. 78, 0. 80 and 0. 79 (P<0. 05). In 18-30 age group, there were significant differences in T2 values among different segments of cervical intervertebral disc (P<0. 01). T2 values in different segments of cervical intervertebral disc in 31-40 age group were significantly lower than those in 18-30 age group (P<0. 01). Conclusion MRI T2-mapping examination has value in evaluation of degeneration of cervical intervertebral disc and changes of ana-tomic segments.