青少年特发性胸腰弯脊柱侧凸伴结构性腰弯患者腰椎椎体磁共振弥散成像参数的变化

Changes of diffusion coefficient values on lumbar vertebra for adolescent idiopathic thoracolumbar scoliosis with structural lumbar curve

中文关键词:  特发性脊柱侧凸  腰椎  磁共振成像  弥散加权成像

英文关键词:Adolescent idiopathic scoliosis  Lumbar vertebra  Magnetic resonance imaging  Diffusion-weighted imaging

中文摘要:

  【摘要】 目的：探讨青少年特发性胸腰弯脊柱侧凸伴结构性腰弯患者腰椎（L1~L5）椎体凹凸侧磁共振弥散加权成像（diffusion-weighted imaging, DWI）参数的变化规律。方法：收集2015年6月~2016年6月在我院就诊的青少年特发性胸腰弯脊柱侧凸伴结构性腰弯的女性患者共30例，年龄10~18岁，Cobb角40°~60°。对患者（侧凸组）及10例同年龄段健康青少年（对照组）腰椎（L1~L5）椎体进行磁共振DWI，测量侧凸患者腰椎椎体凹凸侧及对照组腰椎椎体左右侧表观弥散系数（apparent diffusion coefficient, ADC）值，分别对侧凸患者腰椎椎体凹凸侧及对照组腰椎椎体左右侧ADC值进行比较，同时对侧凸患者和对照组腰椎椎体ADC均值进行比较，分析顶椎椎体凹凸侧ADC差值与Cobb角之间的关系。结果：对照组腰椎各节段间椎体（L1~L5）左侧/右侧的ADC值均无显著性差异（F=0.752，P=0.559；F=0.604，P=0.661）；侧凸组腰椎各节段间椎体凹侧/凸侧的ADC值亦无显著性差异性（F=1.268，P=0.301；F=1.250，P=0.291）。对照组腰椎椎体左侧ADC值与右侧比较无显著性差异[（0.439±0.041）×10－3mm2/s vs （0.423±0.042）×10－3mm2/s，t=1.047，P=0.288]；侧凸组腰椎椎体凹侧ADC值与凸侧比较有显著性差异[（0.391±0.012）×10－3mm2/s vs （0.553±0.037）×10－3mm2/s，P<0.01]，凸侧ADC值与对照组比较显著性增大，凹侧与对照组比较显著性减小。顶椎椎体凹凸侧ADC差值与Cobb角无显著相关性（r=0.024，P=0.721）。结论：青少年特发性胸腰弯脊柱侧凸伴结构性腰弯患者腰椎（L1~L5）椎体凹凸侧DWI参数存在显著性差异。

英文摘要:

  【Abstract】 Objectives: To compare apparent diffusion coefficient(ADC) values on the convex and concave side of lumbar vertebra in diffusion-weighted imaging(DWI) for adolescent idiopathic thoracolumbar scoliosis with structural lumbar curve. Methods: From June 2015 to June 2016, 30 females with adolescent idiopathic thoracolumbar scoliosis with structural lumbar curve were collected, and the ages were between 10 and 18, Cobb angles were from 40° to 60°. The ADC values of lumbar spine(L1-L5) were measured and compared on diffusion-weighted imaging in 30 patients with idiopathic scoliosis and 10 age-matched healthy control subjects. The ADC values of idiopathic scoliosis of concave side and convex side, the left and right sides in two groups were statistically analyzed. Results: According to the ADC values of lumbar vertebre in two groups, there was no significant difference of ADC between the two sides in lumbar segment(L1-L5) in control group(F=0.752, P=0.559; F=0.604, P=0.661). And significant difference was also not found in lumbar segment(L1-L5) in AIS group(F=1.268, P=0.301; F=1.250, P=0.291). The ADC values showed no significant difference between the right and left side in control group[(0.439±0.041)×10－3mm2/s vs (0.423±0.042)×10－3mm2/s, t=1.047, P=0.288]. The statistical difference between the concave side and convex side in AIS group was found[(0.391±0.012)×10－3mm2/s vs (0.553±0.037)×10－3mm2/s, P<0.01]. The mean ADC value of convex side was statistically higher than that of normal control, and the ADC value of concave side was statistically lower than that of normal control. And statistical correlation was not found between ADC values of curve apex vertebra and Cobb angle values(r=0.024, P=0.721). Conclusions: Significant difference of DWI parameter was showed between the two sides of lumbar vertebra in adolescent idiopathic thoracolumbar scoliosis.