Ogon Izaya, Takebayashi Tsuneo, Takashima Hiroyuki, Tanimoto Katsumasa, Ida Kazunori, Yoshimoto Mitsunori, Fujiwara Hiroyoshi, Kubo Toshikazu, Yamashita Toshihiko
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Soutn-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan,
J Orthop Sci. 2015 Mar;20(2):295-301. doi: 10.1007/s00776-014-0686-0. Epub 2015 Feb 5.
Magnetic resonance imaging (MRI) T2 mapping utilizes the T2 values for quantification of moisture content and collagen sequence breakdown. Recently, attempts at quantification of lumbar disc degeneration through MRI T2 mapping have been reported. We conducted an analysis of the relationship between T2 values of degenerated intervertebral discs (IVD) and chronic low back pain (CLBP).
The subjects who had CLBP comprised 28 patients (15 male, 13 female; mean age 48.9 ± 9.6 years; range 22-60 years). All subjects underwent MRI and filled out the low back pain visual analog scale (VAS) and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The disc was divided into the anterior annulus fibrosus (AF), the nucleus pulposus (NP), and the posterior AF, and each T2 value was measured. This study involved 25 asymptomatic control participants matched with the CLBP group subjects for gender and age (13 male, 12 female; mean age 43.8 ± 14.5 years; range 23-60 years). These subjects had no low back pain, and constituted the control group.
T2 values for IVD tended to be lower in the CLBP group than in the control group, and these values were significantly different within the posterior AF. The correlation coefficients between the VAS scores and T2 values of anterior AF, NP and posterior AF were r = 0.30, -0.15 and -0.50. The correlation coefficient between the JOABPEQ scores (low back pain) and T2 values of anterior AF, NP and posterior AF were r = -0.0041, 0.11 and 0.42. Similarly, the JOABPEQ scores (lumbar function) were r = -0.22, -0.12 and 0.57.
The results indicated a correlation between posterior AF degeneration and CLBP. This study suggests that MRI T2 mapping could be used as a quantitative method for diagnosing discogenic pain.
磁共振成像（MRI）T2 映射利用 T2 值来量化水分含量和胶原蛋白序列破坏情况。最近，已有报道尝试通过 MRI T2 映射对腰椎间盘退变进行量化。我们对退变椎间盘（IVD）的 T2 值与慢性下腰痛（CLBP）之间的关系进行了分析。
患有 CLBP 的受试者包括 28 名患者（15 名男性，13 名女性；平均年龄 48.9 ± 9.6 岁；范围 22 - 60 岁）。所有受试者均接受了 MRI 检查，并填写了下腰痛视觉模拟量表（VAS）和日本骨科协会下腰痛评估问卷（JOABPEQ）。将椎间盘分为前纤维环（AF）、髓核（NP）和后纤维环，分别测量每个部位的 T2 值。本研究纳入了 25 名无症状对照参与者，这些参与者在性别和年龄上与 CLBP 组受试者相匹配（13 名男性，12 名女性；平均年龄 43.8 ± 14.5 岁；范围 23 - 60 岁）。这些受试者无下腰痛，构成对照组。
CLBP 组 IVD 的 T2 值往往低于对照组，且在后纤维环内这些值存在显著差异。前纤维环、髓核和后纤维环的 VAS 评分与 T2 值之间的相关系数分别为 r = 0.30、-0.15 和 -0.50。JOABPEQ 评分（下腰痛）与前纤维环、髓核和后纤维环的 T2 值之间的相关系数分别为 r = -0.0041、0.11 和 0.42。同样，JOABPEQ 评分（腰椎功能）分别为 r = -0.22、-0.12 和 0.57。
结果表明后纤维环退变与 CLBP 之间存在相关性。本研究提示 MRI T2 映射可作为诊断椎间盘源性疼痛的定量方法。
