Violas Philippe, Estivalèzes Erik, Pédrono Annaig, de Gauzy J Sales, Sévely Annick, Swider Pascal
Service de Chirurgie Pédiatrique, CHU Pontchaillou, 35033 Rennes, Cedex 09, France.
Magn Reson Imaging. 2005 Apr;23(3):475-9. doi: 10.1016/j.mri.2004.12.004.
The aim of the study was to implement a methodology to quantify in vivo and from magnetic resonance imaging (MRI) the 3D geometrical properties of intervertebral discs (IVDs) in early idiopathic scoliosis with small curves. MRI data were posttreated using a custom-made image processing software to semiautomatically determine the location of disc centres, the location of the nucleus pulposus (NP) and the ratio between the NP volume and the disc volume. MRI was performed in a clinical protocol involving 14 patients having an early idiopathic scoliosis. First, the 3D reconstruction errors were quantified using a reproducibility test (intraoperator and interoperator) in one IVD (L5-S1). The maximal errors in location were 0.79 mm in the frontal plane, 1.84 mm in the sagittal plane and 0.76 mm in the vertical plane. The maximal error in relative volume was 42%. Second, the nucleus migration and relative volume were quantified in discs T5-T6 to L5-S1. No significant relative volume variation was detected. Concerning the disc migration, no significant differences were found in the sagittal and axial planes. In the frontal plane, significant differences were observed at the apex of the scoliotic curvature when the Cobb angle was > or =20 degrees . This innovative study in early scoliosis showed reproducible preliminary results, and its application to improve diagnosis and follow-up will be established in an enlarged patient database.
本研究的目的是实施一种方法,以在体内并通过磁共振成像(MRI)对早期特发性脊柱侧凸小弯曲线的椎间盘(IVD)的三维几何特性进行量化。使用定制的图像处理软件对MRI数据进行后处理,以半自动确定椎间盘中心的位置、髓核(NP)的位置以及NP体积与椎间盘体积之比。在一项涉及14例早期特发性脊柱侧凸患者的临床方案中进行了MRI检查。首先,在一个椎间盘(L5-S1)中使用重复性测试(操作员内和操作员间)对三维重建误差进行量化。位置的最大误差在额平面为0.79毫米,在矢状平面为1.84毫米,在垂直平面为0.76毫米。相对体积的最大误差为42%。其次,对T5-T6至L5-S1椎间盘的髓核迁移和相对体积进行量化。未检测到显著的相对体积变化。关于椎间盘迁移,在矢状面和轴面未发现显著差异。在额平面,当Cobb角≥20度时,在脊柱侧凸曲线的顶点观察到显著差异。这项关于早期脊柱侧凸的创新性研究显示了可重复的初步结果,其在改善诊断和随访方面的应用将在扩大的患者数据库中得以确立。