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支柱:脊柱旁肌肉分段项目 - 一个全面的在线资源,用于指导从磁共振成像中手动分段脊柱旁肌肉。

PILLAR: ParaspInaL muscLe segmentAtion pRoject - a comprehensive online resource to guide manual segmentation of paraspinal muscles from magnetic resonance imaging.

机构信息

Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, QC, H4B 1R6, Canada.

Department of Computer Science and Software Engineering, Concordia University, Montreal, QC, Canada.

出版信息

BMC Musculoskelet Disord. 2023 Nov 23;24(1):909. doi: 10.1186/s12891-023-07029-x.


DOI:10.1186/s12891-023-07029-x
PMID:37996857
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10666451/
Abstract

BACKGROUND: There is an increasing interest in assessing paraspinal morphology and composition in relation to low back pain (LBP). However, variations in methods and segmentation protocols contribute to the inconsistent findings in the literature. We present an on-line resource, the ParaspInaL muscLe segmentAtion pRoject (PILLAR, https://projectpillar.github.io/ ), to provide a detailed description and visual guide of a segmentation protocol by using the publicly available ITK-SNAP software and discuss related challenges when performing paraspinal lumbar muscles segmentations from magnetic resonance imaging (MRI). METHODS: T2-weighted and corresponding fat-water IDEAL axial MRI from 3 males and 3 females (2 chronic LBP and 1 control for each sex) were used to demonstrate our segmentation protocol for each lumbar paraspinal muscle (erector spinae, lumbar multifidus, quadratus lumborum and psoas) and lumbar spinal level (L1-L5). RESULTS: Proper segmentation requires an understanding of the anatomy of paraspinal lumbar muscles and the variations in paraspinal muscle morphology and composition due to age, sex, and the presence of LBP or related spinal pathologies. Other challenges in segmentation includes the presence and variations of intramuscular and epimuscular fat, and side-to-side asymmetry. CONCLUSION: The growing interest to assess the lumbar musculature and its role in the development and recurrence of LBP prompted the need for comprehensive and easy-to-follow resources, such as the PILLAR project to reduce inconsistencies in segmentation protocols. Standardizing manual muscle measurements from MRI will facilitate comparisons between studies while the field is progressively moving towards the automatization of paraspinal muscle measurements for large cohort studies.

摘要

背景:人们越来越感兴趣的是评估与下腰痛(LBP)相关的脊柱旁形态和组成。然而,方法和分割协议的变化导致文献中的结果不一致。我们提出了一个在线资源,即脊柱旁肌肉分割项目(PILLAR,https://projectpillar.github.io/),提供了一个使用公共可用的 ITK-SNAP 软件的分割协议的详细描述和可视化指南,并讨论了在从磁共振成像(MRI)进行脊柱旁腰椎肌肉分割时相关的挑战。

方法:使用来自 3 名男性和 3 名女性(每性别 2 名慢性 LBP 和 1 名对照)的 T2 加权和相应的水脂 IDEAL 轴向 MRI,演示了我们对每个腰椎脊柱旁肌肉(竖脊肌、腰椎多裂肌、腰方肌和腰大肌)和腰椎脊柱水平(L1-L5)的分割协议。

结果:正确的分割需要了解脊柱旁腰椎肌肉的解剖结构以及由于年龄、性别、LBP 或相关脊柱病变的存在而导致的脊柱旁肌肉形态和组成的变化。分割中的其他挑战包括肌内和肌外脂肪的存在和变化,以及侧-侧不对称。

结论:评估腰椎肌肉及其在 LBP 发展和复发中的作用的兴趣日益增加,促使需要全面且易于遵循的资源,如 PILLAR 项目,以减少分割协议中的不一致性。标准化 MRI 上的肌肉手动测量将有助于研究之间的比较,而该领域正在逐步朝着用于大型队列研究的脊柱旁肌肉自动测量方向发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2b/10666451/43dded22e760/12891_2023_7029_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2b/10666451/9e219d3cb7d3/12891_2023_7029_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2b/10666451/75dd38517cb7/12891_2023_7029_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2b/10666451/43dded22e760/12891_2023_7029_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2b/10666451/9e219d3cb7d3/12891_2023_7029_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2b/10666451/75dd38517cb7/12891_2023_7029_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2b/10666451/43dded22e760/12891_2023_7029_Fig3_HTML.jpg

相似文献

[1]
PILLAR: ParaspInaL muscLe segmentAtion pRoject - a comprehensive online resource to guide manual segmentation of paraspinal muscles from magnetic resonance imaging.

BMC Musculoskelet Disord. 2023-11-23

[2]
The assessment of paraspinal muscle epimuscular fat in participants with and without low back pain: A case-control study.

J Biomech. 2024-1

[3]
Population-averaged MRI atlases for automated image processing and assessments of lumbar paraspinal muscles.

Eur Spine J. 2018-7-26

[4]
Is a single-level measurement of paraspinal muscle fat infiltration and cross-sectional area representative of the entire lumbar spine?

Skeletal Radiol. 2018-7

[5]
Comparison of paraspinal muscle composition measurements using IDEAL fat-water and T2-weighted MR images.

BMC Med Imaging. 2023-3-30

[6]
Methodological considerations in region of interest definitions for paraspinal muscles in axial MRIs of the lumbar spine.

BMC Musculoskelet Disord. 2018-5-7

[7]
MRI assessment of paraspinal muscles in patients with acute and chronic unilateral low back pain.

Br J Radiol. 2015-9

[8]
Fatty infiltration of the erector spinae at the upper lumbar spine could be a landmark for low back pain.

Pain Pract. 2024-2

[9]
Facet orientation and tropism: Associations with asymmetric lumbar paraspinal and psoas muscle parameters in patients with chronic low back pain.

J Back Musculoskelet Rehabil. 2016-8-10

[10]
Paraspinal Muscle Changes in Individuals with and without Chronic Low Back Pain over a 4-Month Period: A Longitudinal MRI Study.

Medicina (Kaunas). 2024-3-16

引用本文的文献

[1]
Evaluation of Paraspinal Muscle Epimuscular Fat in Subjects With Low Back Pain in a Tertiary Care Setting.

Cureus. 2025-5-23

[2]
Fat beyond muscle: Assessing epimuscular fat of the lumbar spine and its association with vertebral level, demographics, BMI, and low back pain.

Brain Spine. 2024-10-16

本文引用的文献

[1]
Paraspinal muscle imaging measurements for common spinal disorders: review and consensus-based recommendations from the ISSLS degenerative spinal phenotypes group.

Eur Spine J. 2021-12

[2]
Statistical morphological analysis reveals characteristic paraspinal muscle asymmetry in unilateral lumbar disc herniation.

Sci Rep. 2021-8-2

[3]
Assessing lumbar paraspinal muscle cross-sectional area and fat composition with T1 versus T2-weighted magnetic resonance imaging: Reliability and concurrent validity.

PLoS One. 2021

[4]
Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective.

Pain Pract. 2019-11-11

[5]
Factors Associated With the Ultrasound Characteristics of the Lumbar Multifidus: A Systematic Review.

PM R. 2020-1

[6]
Changes in Structure and Function of the Back Muscles in Low Back Pain: Different Time Points, Observations, and Mechanisms.

J Orthop Sports Phys Ther. 2019-6

[7]
Population-averaged MRI atlases for automated image processing and assessments of lumbar paraspinal muscles.

Eur Spine J. 2018-7-26

[8]
Methodological considerations in region of interest definitions for paraspinal muscles in axial MRIs of the lumbar spine.

BMC Musculoskelet Disord. 2018-5-7

[9]
Prevention and treatment of low back pain: evidence, challenges, and promising directions.

Lancet. 2018-3-21

[10]
Low back pain: a call for action.

Lancet. 2018-3-21

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