Han Zhihua, Gao Liang, Shi Qinglei, Chen Lei, Chen Chun
Department of Orthopaedic Surgery, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, PR China.
Frankfurt Initiative for Regenerative Medicine, JW Goethe-UniversityFrankfurt am Main 60528, Germany.
Am J Transl Res. 2018 Mar 15;10(3):925-935. eCollection 2018.
This study aimed to appraise two quantitative magnetic resonance imaging techniques, T2* imaging and diffusion-weighted imaging (DWI), for the diagnosis of the intervertebral disc degeneration of the cervico-thoracic junction. Influence of specific factors and diagnostic accuracy of both techniques were particularly explored. Sixty-one volunteers with neck and upper back pain were recruited and evaluated with both T2* imaging and DWI. The Pfirrmann grade, T2* relaxation time and apparent diffusion coefficient (ADC) value of each disc between C7 and T3 were recorded. Stratified analyses were performed for different anatomic levels, genders, age ranges and Pfirrmann grades. The diagnostic accuracy of both techniques was investigated using the receiver operating characteristic (ROC) curves. No statistically significant difference of either T2* relaxation time or ADC value was detected between males and females. Both parameters decreased with the increasing age and Pfirrmann grade. The ROC curves showed the higher sensitivity and specificity for T2* imaging than DWI to quantitatively identify the disc degeneration. Particularly, T2* imaging allowed for a quantitative distinguishing the normal, mild and moderate disc degeneration from the severe degeneration, which was unable to accomplish with DWI. In conclusion, we demonstrated that T2* imaging possess a better accuracy than DWI to quantitatively diagnose the intervertebral disc degeneration at the cervico-thoracic junction.
本研究旨在评估两种定量磁共振成像技术，即T2成像和扩散加权成像（DWI），用于诊断颈胸交界处的椎间盘退变。特别探讨了特定因素的影响以及这两种技术的诊断准确性。招募了61名有颈部和上背部疼痛的志愿者，并用T2成像和DWI进行评估。记录了C7至T3之间每个椎间盘的Pfirrmann分级、T2弛豫时间和表观扩散系数（ADC）值。对不同解剖水平、性别、年龄范围和Pfirrmann分级进行了分层分析。使用受试者操作特征（ROC）曲线研究了这两种技术的诊断准确性。男性和女性之间未检测到T2弛豫时间或ADC值有统计学显著差异。这两个参数均随年龄和Pfirrmann分级的增加而降低。ROC曲线显示，T2成像在定量识别椎间盘退变方面比DWI具有更高的敏感性和特异性。特别是，T2成像能够定量区分正常、轻度和中度椎间盘退变与重度退变，而DWI无法做到这一点。总之，我们证明T2*成像在定量诊断颈胸交界处的椎间盘退变方面比DWI具有更高的准确性。
