Tibiletti Marta, Ciavarro Cristina, Bari Vlasta, McCall Iain W, Urban Jill P G, Brayda-Bruno Marco, Galbusera Fabio
1Department of Internal Medicine II-Cardiology, Ulm University, Helmholtzstrasse 16, 89081 Ulm, Germany.
2IRCCS Galeazzi Orthopedic Institute, Via Galeazzi 4, 20161 Milan, Italy.
Eur Radiol Exp. 2017;1(1):5. doi: 10.1186/s41747-017-0009-2. Epub 2017 Jun 29.
Semi-quantitative evaluation of Modic changes (MCs) has recently been proposed as a way to standardise and increase repeatability of clinical studies. This study is aimed at developing semi-quantitative measures of enhancement, given by contrast agent injection, on T1-weighted images in MCs, and to investigate their reliability and relation with MC types.
Thirty-seven subjects suffering from low back pain underwent T1-weighted and T2-weighted turbo spin-echo sequences. Five minutes after the injection of a paramagnetic contrast agent, a second T1-weighted sequence was acquired. Regions of interest (ROIs) corresponding to MCs were selected manually on the unenhanced image; control ROIs in the "healthy" bone marrow were selected. For each ROI, the mean signal intensity (SI) of unenhanced pixels and the mean absolute and normalised difference in SI between unenhanced and contrast-enhanced pixels values were calculated.
A total of 103 MCs were recognised and 61 were semi-quantitatively analysed: 16 type I, 34 type II and 11 type I/II. Regarding controls, MCs I showed a lower SI on the unenhanced T1-weighted images and a marked contrast enhancement (CE); MCs II showed a higher SI than controls on unenhanced images and a lower or comparable CE; and MCs I/II presented an intermediate SI on the unenhanced images and a marked CE. Inter-rater and intra-rater agreements were found to be excellent or substantial.
Semi-quantitative measurements could differentiate MC types in terms of unenhanced SI and of CE with respect to "healthy" bone marrow.
最近有人提出对Modic改变（MCs）进行半定量评估，以此作为一种使临床研究标准化并提高其可重复性的方法。本研究旨在制定基于MCs中T1加权图像上造影剂注射所产生的强化的半定量测量方法，并研究其可靠性以及与MC类型的关系。
37名患有腰痛的受试者接受了T1加权和T2加权快速自旋回波序列检查。注射顺磁性造影剂5分钟后，采集第二次T1加权序列图像。在未增强图像上手动选择与MCs对应的感兴趣区域（ROIs）；在“健康”骨髓中选择对照ROIs。对于每个ROI，计算未增强像素的平均信号强度（SI）以及未增强像素与增强后像素之间SI的平均绝对差值和标准化差值。
共识别出103个MCs，其中61个进行了半定量分析：16个I型，34个II型和11个I/II型。关于对照，I型MCs在未增强的T1加权图像上显示较低的SI和明显的对比增强（CE）；II型MCs在未增强图像上显示比对照更高的SI和较低或相当的CE；I/II型MCs在未增强图像上呈现中等SI和明显的CE。评分者间和评分者内的一致性均为优秀或良好。
半定量测量可以根据未增强SI和相对于“健康”骨髓的CE来区分MC类型。
