Fang Xingyu, Li Jialin, Liu Lin, Zhang Yijun, Tang Zhiquan, Zhang Jinping
Department of Radiology, the 305 Hospital of PLA, Beijing, China.
Department of Laboratory, the 305 Hospital of PLA, Beijing, China.
Quant Imaging Med Surg. 2023 Jan 1;13(1):58-65. doi: 10.21037/qims-22-283. Epub 2022 Sep 22.
Axial loading magnetic resonance imaging (MRI) of lumbar spine is of great significance in the diagnosis of lumbar diseases. However, the axial loading device used in clinic is unique and has some defects. Therefore, we aimed to investigate the effect and examinee comfort of a new device for axial loading lumbar MRI in asymptomatic volunteers.
A new axial loading MRI device for the lumbar spine was developed. A total of 30 asymptomatic individuals underwent conventional lumbar MRI and axial loading lumbar MRI sequentially. The dural sac cross-sectional area (DSCA), sagittal vertebral canal diameter (SVCD), and disc height (DH) at L3-4, L4-5, and L5-S1 before and after axial loading were compared by two experienced radiologists. Examinee comfort during the two examinations was assessed.
All 30 volunteers completed the examinations with the new device. No difference in examinee comfort was found between conventional and axial loading MRI. After axial loading, the DSCA, SVCD, and DH showed the largest decreases at L4-5 followed by L5-S1 and L3-4, with the decreases in DSCA and SVCD at L4-5 being significant (P<0.05). Definite imaging-diagnosable disc herniation or bulging was shown at three intervertebral disc levels of three participants.
The new device could effectively implement axial loading of the lumbar spine without causing obvious discomfort for the examinee. The present study has demonstrated that significant changes occur in the lumbar spine of asymptomatic individuals after axial loading.
腰椎的轴向负荷磁共振成像（MRI）在腰椎疾病的诊断中具有重要意义。然而，临床上使用的轴向负荷装置较为独特且存在一些缺陷。因此，我们旨在研究一种用于无症状志愿者腰椎轴向负荷MRI的新装置的效果及受检者的舒适度。
研发了一种新型的腰椎轴向负荷MRI装置。共有30名无症状个体先后接受了常规腰椎MRI和轴向负荷腰椎MRI检查。由两名经验丰富的放射科医生比较轴向负荷前后L3 - 4、L4 - 5和L5 - S1水平的硬膜囊横截面积（DSCA）、矢状椎管直径（SVCD）和椎间盘高度（DH）。评估两次检查过程中受检者的舒适度。
所有30名志愿者均使用新装置完成了检查。常规MRI和轴向负荷MRI在受检者舒适度方面未发现差异。轴向负荷后，DSCA、SVCD和DH在L4 - 5水平下降幅度最大，其次是L5 - S1和L3 - 4，L4 - 5水平的DSCA和SVCD下降具有显著性（P<0.05）。三名参与者的三个椎间盘水平显示出明确的可成像诊断的椎间盘突出或膨出。
新装置能够有效地对腰椎实施轴向负荷，且不会给受检者带来明显不适。本研究表明，无症状个体在轴向负荷后腰椎会发生显著变化。
