Waldenberg Christian, Brisby Helena, Hebelka Hanna, Lagerstrand Kerstin Magdalena
Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden.
Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
J Clin Med. 2023 Jul 25;12(15):4891. doi: 10.3390/jcm12154891.
Low back pain (LBP) is multifactorial and associated with various spinal tissue changes, including intervertebral disc fissures, vertebral pathology, and damaged endplates. However, current radiological markers lack specificity and individualized diagnostic capability, and the interactions between the various markers are not fully clear. Radiomics, a data-driven analysis of radiological images, offers a promising approach to improve evaluation and deepen the understanding of spinal changes related to LBP. This study investigated possible associations between vertebral changes and annular fissures using radiomics. A dataset of 61 LBP patients who underwent conventional magnetic resonance imaging followed by discography was analyzed. Radiomics features were extracted from segmented vertebrae and carefully reduced to identify the most relevant features associated with annular fissures. The results revealed three important texture features that display concentrated high-intensity gray levels, extensive regions with elevated gray levels, and localized areas with reduced gray levels within the vertebrae. These features highlight patterns within vertebrae that conventional classification systems cannot reflect on distinguishing between vertebrae adjacent to an intervertebral disc with or without an annular fissure. As such, the present study reveals associations that contribute to the understanding of pathophysiology and may provide improved diagnostics of LBP.
腰痛（LBP）是多因素导致的，与多种脊柱组织变化相关，包括椎间盘裂隙、椎体病变和终板损伤。然而，目前的放射学标志物缺乏特异性和个体化诊断能力，且各种标志物之间的相互作用尚不完全清楚。放射组学是一种对放射学图像进行数据驱动分析的方法，为改善对与LBP相关的脊柱变化的评估和加深理解提供了一种有前景的途径。本研究使用放射组学研究椎体变化与椎间盘环裂之间可能存在的关联。分析了61例接受常规磁共振成像检查后再行椎间盘造影的LBP患者的数据集。从分割后的椎体中提取放射组学特征，并仔细筛选以确定与椎间盘环裂相关的最相关特征。结果揭示了三个重要的纹理特征，这些特征表现为椎体内部集中的高强度灰度水平、灰度水平升高的广泛区域以及灰度水平降低的局部区域。这些特征突出了椎体内部的模式，而传统分类系统在区分相邻椎间盘有无环裂的椎体时无法反映这些模式。因此，本研究揭示的关联有助于理解病理生理学，并可能改善LBP的诊断。
