椎间盘源性下腰痛患者脑灰质体积改变的MRI研究

摘要

目的:采用MR基于体素的形态学测量(VBM)技术,探讨椎间盘源性下腰痛患者大脑灰质体积的变化.方法:2016年5月-10月对本院22例椎间盘源性下腰痛患者和22例健康志愿者行3.0T MRI扫描,扫描序列包括T1WI、T2WI和三维快速扰相梯度回波序列T1WI,经图像后处理及统计分析,获得两组受试者大脑灰质形态学差异的相关信息.结果:与对照组比较,下腰痛组患者大脑皮层多个脑区灰质体积减少,包括右侧额上回、左侧额内侧回、左侧直回、右侧颞上回、右侧颞中回、右侧岛叶以及右侧额下回(P＜0.001,FWEc校正);无灰质体积增加的区域.结论:慢性椎间盘源性下腰痛可引起广泛的脑功能区灰质体积的减少,这些脑区主要涉及感觉、认知及情绪,一定程度上揭示了慢性椎间盘源性下腰痛神经系统病变的发生机制.%Objective:To explore the morphometric abnormalities of brain gray matter (GM) in patients with chronic discogenic low back pain (LBP).Methods:22 patients with discogenic LBP and 22 healthy individuals (control group) were enrolled and examined at a 3.0T magnetic resonance scanner using T1WI、T2WI and 3D fast spoiled gradient recall (FSPGR) T1WI sequences.The scanning data were postprocessed and analyzed statistically,information of the morphological differences of the brain GM between the two groups were acquired.Results:Compared with the control group,patients with chronic discogenic LBP showed decreased GM volumes in several brain cortical areas including the right superior frontal gyrus,left medial frontal gyrus,left rectus,right superior temporal gyrus,right medial temporal gyrus,right insula and right inferior frontal gyrus (P＜0.001,FWEc correction);no brain area with increased GM volumes was found.Conclusion:Volume reduction of gray matter can be found in several brain regions in patient with chronic discogenic LBP.These regions are related with sensation,cognitive and emotion.The results lead to a better understanding of the pathogenesis of nervous system due to chronic discogenic LBP.