一种用于评估T2* 成像上腰椎小关节退变生化变化的新四区法。
A new four-area method for evaluating biochemical changes in lumbar facet joint degeneration on T2* mapping.
作者信息
Ding Yi, Ruan Shidong, Liu Liping, Zhang Xiaodong, Chen Rongchun, Chen Qin, Xu Shuaishuai
机构信息
Department of Spine Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, 341000, China.
Department of Spine Surgery, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, Jiangxi, 341000, China.
出版信息
BMC Musculoskelet Disord. 2025 May 15;26(1):480. doi: 10.1186/s12891-025-08737-2.
PURPOSE
To investigate the diagnostic efficacy of a new four-area method for evaluating biochemical changes in lumbar facet joint (LFJ) degeneration on T2* mapping.
METHODS
LFJ degeneration was morphologically graded on T2-weighted imaging using the Weishaupt system. T2* value of LFJ was measured on T2* mapping using both all-inclusive and four-area methods. Inter-observer reliability for continuous and categorical variables was evaluated using intraclass correlation coefficient (ICC) and Kappa value, respectively. The correlation between continuous variables and ordered categorical variables was examined using one way ANOVA or Kruskal-Wallis test, as appropriate.
RESULTS
Fifty-eight patients with LBP underwent standard MRI protocols and axial T2* mapping. In all-inclusive method analysis, the median T2* value of grade 0 LFJ (21.32 [18.27, 26.05]) was higher than those of grade I (18.33 [15.47, 22.16], p < 0.001), grade II LFJ (17.99 [15.18, 20.97], p < 0.001), and grade III LFJ (18.29 [15.07, 25.47], p = 0.178). In four-area method analysis, the median T2* value of grade 0 LFJ (21.55 [18.2, 26.72]) was significantly higher than those of grade I (17.94 [15.45, 21.67], p < 0.001), grade II LFJ (17.28 [14.65, 20.38], p < 0.001) and grade III LFJ (18.25 [15.22, 22.41], p = 0.028). A downward trend in T2* value was observed as LFJ degeneration progressed, except for grade III. Additionally, the median T2* values obtained using all-inclusive method were generally higher than those from four-area method, except for grade 0. Four-area method demonstrated excellent inter-observer reliability with ICC of 0.992 ([0.99, 0.993], p < 0.001), higher than that of all-inclusive method (0.942 [0.931, 0.951], p < 0.001).
CONCLUSIONS
Compared to all-inclusive method, four-area method provides higher reproducibility and accuracy in measuring T2* values. Thus, it is a more reliable approach for assessing biochemical changes in LFJ degeneration on T2* mapping.
目的
探讨一种新的四区法在T2* 成像上评估腰椎小关节（LFJ）退变生化改变的诊断效能。
方法
采用Weishaupt系统在T2加权成像上对LFJ退变进行形态学分级。使用全包法和四区法在T2* 成像上测量LFJ的T2* 值。分别使用组内相关系数（ICC）和Kappa值评估连续变量和分类变量的观察者间可靠性。根据情况，使用单因素方差分析或Kruskal-Wallis检验检查连续变量与有序分类变量之间的相关性。
结果
58例腰痛患者接受了标准MRI检查及轴位T2* 成像。在全包法分析中，0级LFJ的T2* 值中位数（21.32 [18.27, 26.05]）高于I级（18.33 [15.47, 22.16]，p < 0.001）、II级LFJ（17.99 [15.18, 20.97]，p < 0.001）和III级LFJ（18.29 [15.07, 25.47]，p = 0.178）。在四区法分析中，0级LFJ的T2* 值中位数（21.55 [18.2, 26.72]）显著高于I级（17.94 [15.45, 21.67]，p < 0. 001）、II级LFJ（17.28 [14.65, 20.38]，p < 0.001）和III级LFJ（18.25 [15.22, 22.41]，p = 0.028）。除III级外，随着LFJ退变进展，T2* 值呈下降趋势。此外，除0级外，使用全包法获得的T2* 值中位数通常高于四区法。四区法显示出优异的观察者间可靠性，ICC为0.992（[0.99, 0.993]，p < 0.001），高于全包法（0.942 [0.931, 0.951]，p < 0.001）。
结论
与全包法相比，四区法在测量T2* 值时具有更高的可重复性和准确性。因此，它是评估T2* 成像上LFJ退变生化改变的更可靠方法。
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