Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Spine J. 2014 Jul 1;14(7):1343-50. doi: 10.1016/j.spinee.2014.01.031. Epub 2014 Jan 25.
1H magnetic resonance imaging (MRI) of the spine can rule out common causes of low back pain (LBP), such as disc protrusions or nerve root compression; however, no significant causal relation exists between morphology and the extent of symptoms. Functional MRI techniques, such as 23Na, may provide additional information, allowing indirect assessment of vertebral glycosaminoglycan concentrations, decreases in which are associated with early degenerative changes.
To evaluate 23Na-MRI of asymptomatic healthy volunteers and symptomatic patients with LPB and correlate the results to the Pfirrmann classification of MRI disc morphology.
Retrospective cohort study at an academic medical center.
Two groups were studied: (1) 55 healthy volunteers (31 men, 24 women; mean age 28.8 years) and (2) 12 patients (6 men, 6 women; mean age: 35.3 years) with a recent history of LBP.
Lumbar spines of the aforementioned groups were examined on a 3.0 T MRI scanner with morphological 1H and 23Na imaging. Intervertebral disc (IVD) 23Na at each level was normalized (23Nanorm). Distribution and differences between mean 23Nanorm corresponding to each Pfirrmann classification were evaluated in the two study groups (analysis of variance). Linear correlations between 23Nanorm, body mass index (BMI), and age were assessed (Pearson correlation coefficient). Gender-dependent differences were evaluated (paired t test).
Physiological measure: IVD 23Nanorm as determined by 23Na-MRI.
A normal distribution of 23Nanorm was confirmed for both groups (p=.072 and p=.073, respectively). The mean Pfirrmann score statistically significantly differed between them (p<.0001). 23Nanorm was statistically significantly reduced in degenerated IVDs (Pfirrmann scores 4+5) (p<.0001). No statistically significant differences were seen for the mean 23Nanorm of IVDs with the same Pfirrmann score in healthy volunteers and patients (.469<p<.967). Age (0.007<R2<0.202) and BMI (0.074<R2<0.288) showed either weak or no correlation to 23Nanorm. Mean 23Nanorm was significantly (p=.0002) greater in women relative to men.
The results underline the feasibility and robustness of 23Na-MRI of human IVDs and affirm, in a large cohort, decreases in 23Na IVD content seen with disc degeneration.
1H 磁共振成像（MRI）可排除腰痛（LBP）的常见原因，如椎间盘突出或神经根受压；然而，形态学和症状的严重程度之间没有显著的因果关系。23Na 等功能 MRI 技术可提供额外信息，间接评估椎体糖胺聚糖浓度，其降低与早期退行性改变有关。
评估无症状健康志愿者和有腰痛症状的患者的 23Na-MRI，并将结果与 MRI 椎间盘形态的 Pfirrmann 分类相关联。
在学术医疗中心进行的回顾性队列研究。
研究了两组人群：（1）55 名健康志愿者（31 名男性，24 名女性；平均年龄 28.8 岁）和（2）12 名有近期腰痛病史的患者（6 名男性，6 名女性；平均年龄：35.3 岁）。
使用 3.0T MRI 扫描仪对上述两组人群的腰椎进行形态学 1H 和 23Na 成像检查。对每个水平的椎间盘中的 23Na 进行归一化（23Nanorm）。评估两组中每个 Pfirrmann 分类对应的平均 23Nanorm 的分布和差异（方差分析）。评估 23Nanorm、体重指数（BMI）和年龄之间的线性相关性（皮尔逊相关系数）。评估性别相关差异（配对 t 检验）。
生理测量：通过 23Na-MRI 确定的椎间盘中的 23Na 含量。
两组均证实 23Nanorm 呈正态分布（p=.072 和 p=.073）。他们之间的平均 Pfirrmann 评分有统计学差异（p<.0001）。在退变的椎间盘（Pfirrmann 评分 4+5）中，23Nanorm 有统计学显著降低（p<.0001）。在健康志愿者和患者中，具有相同 Pfirrmann 评分的椎间盘的平均 23Nanorm 没有统计学差异（.469<p<.967）。年龄（0.007<R2<0.202）和 BMI（0.074<R2<0.288）与 23Nanorm 呈弱相关或无相关性。女性的平均 23Nanorm 明显高于男性（p=.0002）。
这些结果强调了人体椎间盘 23Na-MRI 的可行性和稳健性，并在大型队列中证实了与椎间盘退变相关的 23Na 椎间盘含量降低。
