腰痛患者腰椎3.0T MR弥散加权成像腰椎间盘表观弥散系数与椎间盘退变分级的相关性

Association between apparent diffusion coefficient and degeneration grading of intervertebral disc in patients with low back pain by using diffusion weighted image at 3.0 Tesla MR

中文关键词:  腰痛  磁共振成像  弥散加权成像  表观弥散系数  腰椎间盘  退变

英文关键词:Low back pain  Magnetic resonance imaging  Diffusion weighted imaging  Apparent diffusion coefficient  Lumbra intervertebral disc  Degeneration

中文摘要:

  【摘要】 目的：分析腰痛患者腰椎3.0T MR弥散加权成像（diffusion weighted image，DWI）椎间盘的表观弥散系数（apparent diffusion coefficient，ADC）与椎间盘退变形态学分级的相关性。方法：2012年6月~2012年11月对60例腰痛患者行腰椎3.0T MR T2加权成像（T2 weighted image, T2WI）和DWI扫描。男30例，女30例，年龄19～66岁，平均42.5±11.9岁。在MR常规T2WI序列上对腰椎间盘按Pfirrmann标准进行形态学分级，在矢状面ADC图上对正中层面椎间盘进行ADC值测量。对腰椎间盘ADC值与Pfirrmann分级之间的相关性采用Spearman相关分析，并对椎间盘不同Pfirrmann分级的ADC值进行单因素方差分析，如有差异进一步进行LDS法两两检验。结果： 腰椎间盘Pfirrmann分级为Ⅰ级45个（15%），Ⅱ级61个（20.3%），Ⅲ级74个（24.7%），Ⅳ级113个（37.7%），Ⅴ级7个（2.3%）。Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ级椎间盘的ADC值分别为1.73±0.21、1.74±0.15、1.62±0.24、1.23±0.37、0.81±0.32（10-3mm2/s）。腰椎间盘不同Pfirrmann分级的ADC值有显著性差异（F=56.9，P=0.000），不同分级间差异进一步行LDS法两两检验，Ⅰ级的ADC值与Ⅱ级比较无显著性差异（P＞0.05），Ⅲ级、Ⅳ级、Ⅴ级分别与Ⅰ级、Ⅱ级比较均有显著性差异（P＜0.05），Ⅲ级、Ⅳ级、Ⅴ级之间两两比较均有显著性差异（P＜0.05）。腰椎间盘ADC值与其Pfirrmann分级呈明显负相关（r=-0.624，P=0.000）。结论： 腰痛患者腰椎3.0T MR DWI腰椎间盘的ADC值与椎间盘退变分级呈负相关。

英文摘要:

  【Abstract】 Objectives: To assess the correlation between apparent diffusion coefficient(ADC) of lumbar intervertebral disc on diffusion weighted image(DWI) and degeneration grading of intervertebral disc in patients with low back pain. Methods: From June to November 2012, T2 weighted image(T2WI) and DWI sequence of lumbar spine were performed on 60 patients with low back pain by using a 3.0T MR scanner. There were 30 males and 30 females, with the age ranging at 19-66 years(average, 42.5±11.9 years). The Pfirrmann grading was performed on T2WI sequence. ADC values of intervertebral discs were measured in middle slice of sagittal ADC mapping. The correlation between ADC values and Pfirrmann grading was tested by Spearman analysis. One-way ANOVE was used to test the difference on ADC values among various Pfirrmann grading of intervertebral discs. LDS method was used to furtherly test if the difference was significant. Results: Pfirrmann grading of intervertebral discs in patients with lower back pain was as following: grading Ⅰ, 45 discs (15%); grading Ⅱ, 74 discs(24.7%); grading Ⅲ, 74 discs(24.7%); grading Ⅳ, 113 discs(37.7%); grading Ⅴ, 7 discs(2.3%). The ADC value of Pfirrmann grading Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ was 1.73±0.21, 1.74±0.15, 1.62±0.24, 1.23±0.37, 0.81±0.32(10-3mm2/s), respectively. Significant difference on ADC values was found among various Pfirrmann grading levels, with F=56.9, P=0.000. While further test by using LDS method showed no significant difference on ADC values between Pfirrmann grading Ⅰ and grading Ⅱ(P>0.05). Significant differences on ADC values were found between any two levels of Pfirrmann grading Ⅲ, grading Ⅳ, and grading Ⅴ(P<0.05). Negative correlation was found between ADC values and Pfirrmann grading(r=-0.642, P=0.000). Conclusions: Negative correlation between ADC values and degeneration grading of lumbar intervertebral discs in patients with low back pain exists by using 3.0T MR DWI.