Stefanou D E, Velonakis G, Karavasilis E, Argyropoulos G, Kelekis A, Kelekis N, Filippiadis D
2 Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian, University of Athens, Athens.
Hippokratia. 2023 Jul-Sep;27(3):75-81.
To assess the feasibility of using T2 relaxation time mapping at 3 Tesla (3T) magnetic resonance imaging (MRI) for detection and classification of lumbar intervertebral disc degeneration, introducing an objective model of disc segmentation for accurate disc assessment.
The present study is a single-center prospective evaluation including 185 lumbar intervertebral discs from a cohort of 37 patients with chronic lower back pain. For the quantitative classification of disc degeneration, three regions of interest (ROIs) were drawn on T2 maps, and the Pfirrmann grading system was used for qualitative assessment. Intergroup evaluation was performed with paired t-tests. Analysis of variance (ANOVA) was used to compare the mean value of T2 mapping, and Tukey's multiple comparison test was applied to determine differences in mean values of T2 mapping among the Pfirrmann categories.
The ANOVA test analysis of ROIs showed that there is a statistically significant difference (p <0.001) among average T2 relaxation time mapping values in different Pfirrmann score groups, and Tukey's multiple comparison tests revealed that mean values of T2 map among the different grades of Pfirrmann differ from the rest (p <0.001) except grade V. Paired t-tests revealed significant differences in mean values of T2 map between different ROIs.
This study showed that quantitative T2 mapping of the lumbar intervertebral discs at 3T MRI may overcome the subjective element of qualitative classification systems for degenerative intervertebral disc disease. Also, a new template of disc segmentation with more ROIs would be more sensitive for the assessment of disc degeneration. HIPPOKRATIA 2023, 27 (2):75-81.
评估在3特斯拉（3T）磁共振成像（MRI）中使用T2弛豫时间映射检测和分类腰椎间盘退变的可行性，引入一种用于准确椎间盘评估的客观椎间盘分割模型。
本研究为单中心前瞻性评估，纳入了37例慢性下腰痛患者队列中的185个腰椎间盘。为了对椎间盘退变进行定量分类，在T2图上绘制了三个感兴趣区域（ROI），并使用Pfirrmann分级系统进行定性评估。采用配对t检验进行组间评估。使用方差分析（ANOVA）比较T2映射的平均值，并应用Tukey多重比较检验确定Pfirrmann类别之间T2映射平均值的差异。
对ROI的ANOVA检验分析表明，不同Pfirrmann评分组的平均T2弛豫时间映射值之间存在统计学显著差异（p<0.001），Tukey多重比较检验显示，除V级外，不同Pfirrmann等级的T2图平均值与其他等级存在差异（p<0.001）。配对t检验显示不同ROI之间T2图平均值存在显著差异。
本研究表明，3T MRI对腰椎间盘进行定量T2映射可能克服了椎间盘退变定性分类系统的主观因素。此外，具有更多ROI的新型椎间盘分割模板对椎间盘退变的评估可能更敏感。《希波克拉底》2023年，27（2）：75 - 81。
