Mannil Manoj, Burgstaller Jakob M, Thanabalasingam Arjun, Winklhofer Sebastian, Betz Michael, Held Ulrike, Guggenberger Roman
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistrasse 24, 8032, Zurich, Switzerland.
Skeletal Radiol. 2018 Jul;47(7):947-954. doi: 10.1007/s00256-018-2919-3. Epub 2018 Mar 1.
To evaluate association of fatty infiltration in paraspinal musculature with clinical outcomes in patients suffering from lumbar spinal stenosis (LSS) using qualitative and quantitative grading in magnetic resonance imaging (MRI).
In this retrospective study, texture analysis (TA) was performed on postprocessed axial T2 weighted (w) MR images at level L3/4 using dedicated software (MaZda) in 62 patients with LSS. Associations in fatty infiltration between qualitative Goutallier and quantitative TA findings with two clinical outcome measures, Spinal stenosis measure (SSM) score and walking distance, at baseline and regarding change over time were assessed using machine learning algorithms and multiple logistic regression models.
Quantitative assessment of fatty infiltration using the histogram TA feature "mean" showed higher interreader reliability (ICC 0.83-0.97) compared to the Goutallier staging (κ = 0.69-0.93). No correlation between Goutallier staging and clinical outcome measures was observed. Among 151 TA features, only TA feature "mean" of the spinotransverse group showed a significant but weak correlation with worsened SSM (p = 0.046). TA feature "S(3,3) entropy" showed a significant but weak association with worsened WD over 12 months (p = 0.046).
MR TA is a reproducible tool to quantitatively assess paraspinal fatty infiltration, but there is no clear association with the clinical outcome in asymptomatic LSS patients.
利用磁共振成像（MRI）的定性和定量分级，评估腰椎管狭窄症（LSS）患者椎旁肌肉组织脂肪浸润与临床结局之间的关联。
在这项回顾性研究中，使用专用软件（MaZda）对62例LSS患者L3/4水平的轴向T2加权（w）MRI后处理图像进行纹理分析（TA）。使用机器学习算法和多元逻辑回归模型，评估定性的Goutallier分级和定量TA结果与两种临床结局指标（椎管狭窄测量（SSM）评分和步行距离）在基线时以及随时间变化的脂肪浸润之间的关联。
与Goutallier分级（κ = 0.69 - 0.93）相比，使用直方图TA特征“均值”对脂肪浸润进行定量评估显示出更高的阅片者间可靠性（ICC 0.83 - 0.97）。未观察到Goutallier分级与临床结局指标之间的相关性。在151个TA特征中，只有棘横肌组的TA特征“均值”与SSM恶化呈显著但较弱的相关性（p = 0.046）。TA特征“S(3,3)熵”与12个月内步行距离恶化呈显著但较弱的关联（p = 0.046）。
MR TA是一种可重复的工具，用于定量评估椎旁脂肪浸润，但与无症状LSS患者的临床结局无明确关联。
