Takashima Hiroyuki, Takebayashi Tsuneo, Ogon Izaya, Yoshimoto Mitsunori, Morita Tomonori, Imamura Rui, Nakanishi Mitsuhiro, Nagahama Hiroshi, Terashima Yoshinori, Yamashita Toshihiko
1 Department Orthopaedic Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido , Japan.
2 Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital , Sapporo, Hokkaido , Japan.
Br J Radiol. 2018 Feb;91(1083):20170536. doi: 10.1259/bjr.20170536. Epub 2018 Jan 2.
To analyse the intra- (IMCL) and extramyocellular lipids (EMCL) concentration in the multifidus muscle (Mm) using MR spectroscopy (MRS) in patients with low back pain (LBP), and to evaluate the correlation between those lipid concentrations and age, obesity, atrophy of the Mm and LBP intensity.
60 LBP patients underwent routine diagnostic MRI of the lumbar spine before undergoing imaging for the study. Body mass index, as an indicator of obesity and visual analogue scale, as an indicator of LBP were also measured. Proton MRS was acquired with a single-voxel point-resolved spectroscopy sequence. Furthermore, the MRS volume of interest for measuring the IMCL and EMCL concentration at L4/5 for the right Mm was determined, and we measured the cross-sectional area of Mm as an indicator of muscle atrophy.
Age showed correlation with EMCL concentration (r = 0.314, p = 0.008). The body mass index showed correlation with EMCL concentration (r = 0.358, p = 0.005). The cross-sectional area of Mm showed correlation with EMCL concentration (r = -0.543, p < 0.001). Moreover, the LBP visual analogue scale showed correlation with IMCL concentration (r = 0.367, p = 0.004).
There were correlations between age, obesity, muscle atrophy, and EMCL concentration in Mm. IMCL concentration in Mm showed a correlation with LBP intensity. This may suggest that IMCL concentration could become an effective objective indicator of chronic LBP intensity. Advances in knowledge: We investigated the characteristics of fat content in Mm with LBP patients. This study was demonstrated the association of the IMCL and EMCL concentration in Mm with various patient parameters.
采用磁共振波谱（MRS）分析下腰痛（LBP）患者多裂肌（Mm）内的肌内脂质（IMCL）和肌外脂质（EMCL）浓度，并评估这些脂质浓度与年龄、肥胖、Mm萎缩及LBP强度之间的相关性。
60例LBP患者在接受本研究成像检查前接受了腰椎常规诊断性MRI检查。还测量了作为肥胖指标的体重指数和作为LBP指标的视觉模拟评分。采用单体素质子磁共振波谱序列采集质子MRS。此外，确定了用于测量右侧Mm在L4/5水平IMCL和EMCL浓度的MRS感兴趣区，并测量了Mm的横截面积作为肌肉萎缩的指标。
年龄与EMCL浓度相关（r = 0.314，p = 0.008）。体重指数与EMCL浓度相关（r = 0.358，p = 0.005）。Mm的横截面积与EMCL浓度相关（r = -0.543，p < 0.001）。此外，LBP视觉模拟评分与IMCL浓度相关（r = 0.367，p = 0.004）。
年龄、肥胖、肌肉萎缩与Mm内的EMCL浓度之间存在相关性。Mm内的IMCL浓度与LBP强度相关。这可能表明IMCL浓度可能成为慢性LBP强度的有效客观指标。知识进展：我们研究了LBP患者Mm中脂肪含量的特征。本研究证明了Mm中IMCL和EMCL浓度与各种患者参数之间的关联。
