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慢性腰痛患者脊柱旁肌肉 CSA 和 PDFF 测量与腰椎间盘退变的相关性。

Association of Paraspinal Muscle CSA and PDFF Measurements With Lumbar Intervertebral Disk Degeneration in Patients With Chronic Low Back Pain.

机构信息

Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China.

Department of Radiology, Beijing Jishuitan Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2022 May 26;13:792819. doi: 10.3389/fendo.2022.792819. eCollection 2022.

DOI:10.3389/fendo.2022.792819
PMID:35721738
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9204273/
Abstract

There is an interaction between the lumbar spine and paraspinal muscles, which may play a role in the development of intervertebral disc (IVD) degeneration and may affect CLBP. The study aims to assess the relationship between IVD degeneration and paraspinal muscle fat infiltration in CLBP patients by quantitative MR imaging, and to evaluate the influence of sex and age on CLBP muscle fat infiltration. Sixty CLBP patients (46.3 years ±17.0) and thirty-two healthy subjects (44.9 years ±17.6) were recruited for this study. 3.0 T MRI was used to perform the sagittal and axial T1, T2 of the lumbar spine, and axial paraspinal muscle IDEAL imaging at the L4/5 and L5/S1 levels. Proton density fat fraction (PDFF) of the multifidus and erector spinae at two IVD levels were measured. The Pfirrmann grades of IVD degeneration, Oswestry Disability Index (ODI), and Visual Analog Scale (VAS) were also evaluated. Compare the cross-sectional area (CSA) and PDFF of the paraspinal muscles between CLBP patients and healthy subjects, and analyze the relationship between the muscle PDFF and Pfirrmann grades, gender, and age of CLBP patients. Compared with healthy subjects, the CSA of the multifidus muscle in CLBP patients decreased (1320.2±188.1mm 1228.7±191.0 mm, <0.05) at the L4/5 level, the average PDFF increased, (7.7±2.6% 14.79±5.3%, 8.8±4.2% 16.03±5.3%, all <0.05) at both L4/5 and L5/S1 levels. The PDFF of paraspinal muscles were correlated with adjacent IVD degeneration, ODI and VSA in CLBP patients (all <0.05). After using age and body mass index (BMI) as control variables, significance was retained (all p<0.05). Multiple regression analysis revealed sex and age also were significantly associated with multifidus PDFF (all < 0.05). This study confirmed that the CSA decreased and the PDFF increased of the paraspinal muscles in CLBP patients. It reveals a significant correlation between the PDFF of CLBP paraspinal muscles and the grade of IVD degeneration. Sex and age are also important factors influencing CLBP paraspinal muscle infiltration.

摘要

腰椎和腰背肌之间存在相互作用，这种相互作用可能在椎间盘（IVD）退变的发生中起作用，并可能影响慢性下腰痛（CLBP）。本研究旨在通过定量磁共振成像评估 CLBP 患者的 IVD 退变与腰背肌脂肪浸润之间的关系，并评估性别和年龄对 CLBP 肌肉脂肪浸润的影响。本研究共纳入 60 例 CLBP 患者（46.3 岁±17.0 岁）和 32 例健康对照者（44.9 岁±17.6 岁）。所有受试者均行 3.0T MRI 矢状位和轴位 T1、T2 及 L4/5、L5/S1 水平轴向的腰背肌 IDEAL 成像。测量两个 IVD 水平多裂肌和竖脊肌的质子密度脂肪分数（PDFF）。同时评估 IVD 退变的 Pfirrmann 分级、Oswestry 功能障碍指数（ODI）和视觉模拟评分（VAS）。比较 CLBP 患者和健康对照者腰背肌的横截面积（CSA）和 PDFF，并分析 CLBP 患者肌肉 PDFF 与 Pfirrmann 分级、性别和年龄的关系。与健康对照组相比，CLBP 患者 L4/5 水平多裂肌 CSA 减小（1320.2±188.1mm 比 1228.7±191.0mm，<0.05），平均 PDFF 增加（7.7±2.6%比 14.79±5.3%，8.8±4.2%比 16.03±5.3%，均<0.05），L4/5 和 L5/S1 水平多裂肌和竖脊肌的 PDFF 均与邻近 IVD 退变、ODI 和 VAS 呈正相关（均<0.05）。校正年龄和体重指数（BMI）后，差异仍有统计学意义（均 p<0.05）。多元回归分析显示，性别和年龄也是多裂肌 PDFF 的显著相关因素（均<0.05）。本研究证实，CLBP 患者腰背肌 CSA 减小，PDFF 增加，CLBP 腰背肌 PDFF 与 IVD 退变程度呈显著正相关。性别和年龄也是影响 CLBP 腰背肌浸润的重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/4f54691fad11/fendo-13-792819-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/62ec94f6425c/fendo-13-792819-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/554883a736f1/fendo-13-792819-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/9b2a7a1d38c2/fendo-13-792819-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/8924df843feb/fendo-13-792819-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/72e38f0d9594/fendo-13-792819-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/4f54691fad11/fendo-13-792819-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/62ec94f6425c/fendo-13-792819-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/554883a736f1/fendo-13-792819-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/9b2a7a1d38c2/fendo-13-792819-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/8924df843feb/fendo-13-792819-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/72e38f0d9594/fendo-13-792819-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0f/9204273/4f54691fad11/fendo-13-792819-g006.jpg

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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
MRI-Determined Psoas Muscle Fat Infiltration Correlates with Severity of Weight Loss during Cancer Cachexia.

Cancers (Basel). 2021-9-2

[2]
Association of Elbow Flexor MRI Fat Fraction With Loss of Hand-to-Mouth Movement in Patients With Duchenne Muscular Dystrophy.

Neurology. 2021-10-26

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J Magn Reson Imaging. 2021-7

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Cartilage. 2021-12

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Eur Radiol. 2021-5

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Muscle density discriminates hip fracture better than computed tomography X-ray absorptiometry hip areal bone mineral density.

J Cachexia Sarcopenia Muscle. 2020-12

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Muscle Density, but Not Size, Correlates Well With Muscle Strength and Physical Performance.

J Am Med Dir Assoc. 2021-4

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Age-related fatty infiltration of lumbar paraspinal muscles: a normative reference database study in 516 Chinese females.

Quant Imaging Med Surg. 2020-8

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