Luo Muqing, Deng Huiting, Ma Menqtian, Liu Yinqi, Zhong Zeya, Li Jianyu, Zhang Kun
Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, ChangSha, China.
Department of Radiology, Longhua District Central Hospital, Shenzhen, China.
Eur Spine J. 2025 Jun 5. doi: 10.1007/s00586-025-08968-w.
To quantitatively assess lumbar paraspinal muscle degeneration and gender-related differences during aging in adults using rapid kVp switching dual-energy computed tomography (DECT).
A total of 156 healthy adults underwent lumbar DECT scans and were prospectively grouped into young (20-39 years), middle-aged (40-59 years), and elderly (60-79 years) groups. Muscle density (MD), cross-sectional area (CSA), muscle content (MC), and water content (WC) were measured using muscle-water decomposition images for the bilateral erector spinae (ES) at the L1/2 to L4/5 levels and bilateral multifidus (MF) and psoas (PS) at the L2/3 to L5/S1 levels.
Across age groups, significant differences in paraspinal muscle MD and WC were observed (P < 0.01), with MD negatively and WC positively correlated with age at lower lumbar levels for both MF and ES (P < 0.001). In females, except for the L5/S1 PS, WC differences between the middle-aged and elderly groups were significant (P < 0.05), but not between the young and middle-aged groups (P > 0.05). In males, multifidus MC at L4/5 decreased with age (P < 0.05), while in females, multifidus MC at L3/4 and L5/S1 were higher in the middle-aged group and lowest in the elderly group (P < 0.05). PS CSA at L4/5-L5/S1 showed a moderate negative correlation with age (P < 0.001). The Kruskal-Wallis H test and one-way ANOVA were used to compare paraspinal muscle parameters across age groups, while Spearman and Linear regression analyses assessed their associations with age.
The DECT muscle-water decomposition technique enables noninvasive, quantitative assessment of lumbar paraspinal muscle composition. Notably, age-related decreases in MC and increases in WC, along with gender-specific differences, may serve as early biomarkers for muscle aging and degeneration, supporting personalized evaluation and intervention.
使用快速千伏切换双能计算机断层扫描（DECT）对成年人衰老过程中的腰椎旁肌肉退变及性别差异进行定量评估。
共有156名健康成年人接受了腰椎DECT扫描，并被前瞻性地分为青年组（20 - 39岁）、中年组（40 - 59岁）和老年组（60 - 79岁）。使用肌肉 - 水分解图像测量L1/2至L4/5水平双侧竖脊肌（ES）以及L2/3至L5/S1水平双侧多裂肌（MF）和腰大肌（PS）的肌肉密度（MD）、横截面积（CSA）、肌肉含量（MC）和含水量（WC）。
在各年龄组中，观察到腰椎旁肌肉MD和WC存在显著差异（P < 0.01），对于MF和ES，在下腰椎水平MD与年龄呈负相关，WC与年龄呈正相关（P < 0.001）。在女性中，除了L5/S1水平的PS，中年组和老年组之间的WC差异显著（P < 0.05），但青年组和中年组之间差异不显著（P > 0.05）。在男性中，L4/5水平的多裂肌MC随年龄下降（P < 0.05），而在女性中，L3/4和L5/S1水平的多裂肌MC在中年组中较高，在老年组中最低（P < 0.05）。L4/5 - L5/S1水平的PS CSA与年龄呈中度负相关（P < 0.001）。使用Kruskal - Wallis H检验和单因素方差分析比较各年龄组的腰椎旁肌肉参数，同时使用Spearman和线性回归分析评估它们与年龄的关联。
DECT肌肉 - 水分解技术能够对腰椎旁肌肉组成进行无创、定量评估。值得注意的是，与年龄相关的MC下降和WC增加以及性别特异性差异，可能作为肌肉衰老和退变的早期生物标志物，支持个性化评估和干预。
