Gullbrand Sarah E, Ashinsky Beth G, Martin John T, Pickup Stephen, Smith Lachlan J, Mauck Robert L, Smith Harvey E
Department of Orthopaedic Surgery, McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania.
Translational Musculoskeletal Research Center, Philadelphia VA Medical Center, Philadelphia, Pennsylvania.
J Orthop Res. 2016 Aug;34(8):1382-8. doi: 10.1002/jor.23269. Epub 2016 Aug 10.
Improved diagnostic measures for intervertebral disc degeneration are necessary to facilitate early detection and treatment. The aim of this study was to correlate changes in mechanical and biochemical properties with the quantitative MRI parameters T2 and T1ρ in rabbit lumbar discs using an ex vivo chymopapain digestion model. Rabbit lumbar spinal motion segments from animals less than 6 months of age were injected with 100 μl of saline (control) or chymopapain at 3, 15, or 100 U/ml (n = 5 per group). T2 and T1ρ MRI series were obtained at 4.7T. Specimens were mechanically tested in tension-compression and creep. Normalized nucleus pulposus (NP) water and GAG contents were quantified. Stepwise multiple linear regression was performed to determine which parameters contributed significantly to changes in NP T2 and T1ρ. When all groups were included, multiple regression yielded a model with GAG, compressive modulus, and the creep time constants as variables significantly impacting T2 (multiple r(2) = 0.64, p = 0.006). GAG and neutral zone (NZ) modulus were identified as variables contributing to T1ρ (multiple r(2) = 0.28, p = 0.08). When specimens with advanced degeneration were excluded from the multiple regression analysis, T2 was significantly predicted by compressive modulus, τ1, and water content (multiple r(2) = 0.71, p = 0.009), while no variables were significant predictors in the model for T1ρ. These results indicate that quantitative MRI can detect changes in the mechanical and biochemical properties of the degenerated disc. T2 may be more sensitive to early stage degenerative changes than T1ρ, while both quantitative MRI parameters are sensitive to advanced degeneration. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1382-1388, 2016.
为了便于早期发现和治疗,需要改进椎间盘退变的诊断方法。本研究的目的是使用离体木瓜凝乳蛋白酶消化模型,将兔腰椎间盘的力学和生化特性变化与定量MRI参数T2和T1ρ相关联。对6个月龄以下动物的兔腰椎运动节段注射100μl生理盐水(对照组)或3、15或100U/ml的木瓜凝乳蛋白酶(每组n = 5)。在4.7T下获得T2和T1ρ MRI序列。对标本进行拉伸-压缩和蠕变力学测试。对正常化的髓核(NP)水和糖胺聚糖(GAG)含量进行定量。进行逐步多元线性回归以确定哪些参数对NP T2和T1ρ的变化有显著贡献。当纳入所有组时,多元回归产生一个以GAG、压缩模量和蠕变时间常数为变量的模型,这些变量对T2有显著影响(多元r(2) = 0.64,p = 0.006)。GAG和中性区(NZ)模量被确定为对T1ρ有贡献的变量(多元r(2) = 0.28,p = 0.08)。当在多元回归分析中排除晚期退变的标本时,压缩模量、τ1和含水量可显著预测T2(多元r(2) = 0.71,p = 0.009),而在T1ρ模型中没有变量是显著的预测因子。这些结果表明,定量MRI可以检测退变椎间盘的力学和生化特性变化。T2可能比T1ρ对早期退变变化更敏感,而这两个定量MRI参数对晚期退变都敏感。© 2016骨科研究协会。由威利期刊公司出版。《矫形外科学研究》34:1382 - 1388,2016。