上背部疼痛患者椎间盘退变的T2弛豫时间：3.0特斯拉磁共振成像临床应用的初步结果
T2 relaxation time for intervertebral disc degeneration in patients with upper back pain: initial results on the clinical use of 3.0 Tesla MRI.
作者信息
Xie Raoying, Ruan Linhui, Chen Lei, Zhou Kai, Yuan Jiandong, Ji Wei, Jing Guangjian, Huang Xiaojing, Shi Qinglei, Chen Chun
机构信息
Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China.
Department of Radiation and chemotherapy division, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
出版信息
BMC Med Imaging. 2017 Jan 31;17(1):9. doi: 10.1186/s12880-017-0182-z.
BACKGROUND
Magnetic resonance imaging (MRI) is a useful non-invasive tool for evaluating abnormalities of intervertebral discs. However, there are few studies which applied functional MRI techniques to investigate degenerative changes in cervical and cervicothoracic junction (CTJ) spine among adults. The aim of this study was to compare T2 relaxation time measurement evaluation with morphological grading for assessing cervical and CTJ intervertebral discs (IVD) in the patients suffering neck, shoulder, and upper back pain.
METHODS
Sixty-three patients (378 IVDs) and 60 asymptomatic volunteers (360 IVDs) of the cervical and CTJ discs were assessed using a 3.0 T magnetic resonance imaging (MRI) protocol, including an sagittal T2 relaxation time protocol. The relaxation time values of the nucleus pulposus (NP) were recorded and all discs were visually graded according to Pfirrman's grading system. The correlation between T2 relaxation time values and qualitative clinical grading of degeneration, patient age, sex and anatomic level were analyzed RESULTS: There is a clear trend of decreasing mean T2 values of the NP associate with increasing Pfirrmann grades (C2-T1) for both patients and asymptotic volunteers. Significant T2 differences were seen among grades I-V (P < 0.05). However, grade V was not observed in the CTJ. Linear correlation analysis revealed a strong negative association between T2 values of the NP and Pfirrmann grade (r = -0.588, r = -0.808) of C2-7 and C7T1. Age were also significantly correlated NP T2 values (r = -0.525, r = -0.723) for patients and volunteers. Moreover, the receiver operating characteristic analysis for average measures in a range from 0.70-0.79 (C2-7) to 0.84-0.89 (C7T1) for patients.
CONCLUSIONS
T2 quantitation provides a more sensitive and robust approach for detecting and characterizing the early stage of IVD degeneration and age-associated disc changes.
背景
磁共振成像（MRI）是评估椎间盘异常的一种有用的非侵入性工具。然而，很少有研究应用功能MRI技术来研究成年人颈椎和颈胸交界区（CTJ）脊柱的退变情况。本研究的目的是比较T2弛豫时间测量评估与形态学分级，以评估颈部、肩部和上背部疼痛患者的颈椎和CTJ椎间盘（IVD）。
方法
使用3.0 T磁共振成像（MRI）方案，包括矢状面T2弛豫时间方案，对63例患者（378个IVD）和60名无症状志愿者（360个IVD）的颈椎和CTJ椎间盘进行评估。记录髓核（NP）的弛豫时间值，并根据Pfirrman分级系统对所有椎间盘进行视觉分级。分析T2弛豫时间值与退变的定性临床分级、患者年龄、性别和解剖水平之间的相关性。结果：对于患者和无症状志愿者，NP的平均T2值均有随着Pfirrmann分级（C2-T1）增加而降低的明显趋势。I-V级之间T2值存在显著差异（P < 0.05）。然而，在CTJ未观察到V级。线性相关分析显示，C2-7和C7T1的NP的T2值与Pfirrmann分级之间存在强负相关（r = -0.588，r = -0.808）。年龄与患者和志愿者的NP T2值也显著相关（r = -0.525，r = -0.723）。此外，患者的平均测量值的受试者工作特征分析范围为0.70 - 0.79（C2-7）至0.84 - 0.89（C7T1）。
结论
T2定量为检测和表征IVD退变的早期阶段以及与年龄相关的椎间盘变化提供了一种更敏感和可靠的方法。
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