测量腰椎磁共振横切面上椎间盘及髓核信号评估椎间盘退变的可行性研究

发布时间：2018-02-28 18:19

本文关键词： 测量腰椎磁共振横切面上椎间盘髓核信号评估变的可行性研究　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨在横切面磁共振图像测量腰椎间盘及髓核信号用以评估椎间盘退变的可行性。方法:收集一般人群腰椎磁共振扫描图像。在T2加权像上利用影像分析软件Spine Explorer手工选取正中矢状位椎间盘和横切面椎间盘及髓核的区域,其中横切面上髓核面积为椎间盘的58%,测量横切面图像L1-S1椎间盘、髓核平均信号和信号标准差及邻近后方脑脊液平均信号;测量矢状位图像椎间盘平均信号和信号标准差及邻近后方脑脊液平均信号。信号测量均以临近脑脊液平均信号予以校正。计算信号测量值与年龄相关性(相关系数,r),对比横切面椎间盘、髓核信号及矢状位椎间盘信号与年龄的相关系数,评估腰椎间盘退变各种测量方法的有效性。间隔一个月选取其中20例,再次测量各信号值,计算各测量方法的可信度(ICC)。P0.05定义为统计学有意义。结果:研究纳入66例一般人群样本,男33例,女33例,平均年龄50.3±16.5岁(24-82岁),共分析测量330个腰椎间盘T2加权像上的信号。矢状位上椎间盘平均信号测量和信号标准差只有中度的测量可信度(ICC=0.63和0.73),横切面上椎间盘及髓核的信号测量表现为极强的可信度(ICC0.80)。T2W像正中矢状位椎间盘平均信号和信号标准差与年龄有较好的相关性(r分别为-0.50和-0.67,P0.001);横切面上,椎间盘信号标准差与年龄中度负相关(r=-0.41,P0.01),而平均信号与年龄没有相关性(P=0.319);横切面髓核平均信号与年龄表现出中度负相关(r=-0.41,P0.01),而信号标准差与年龄无显著性统计相关性(P=0.058)。当将腰椎分为上腰椎(L1-L4)和下腰椎(L4-S1)分析对比信号与年龄相关性时,我们发现上腰椎表现出与上述一致的结果,而在下腰椎中,横切面上除了髓核平均信号与年龄表现出较弱的相关性(r=-0.30,P0.05)外,余横切面信号量化指标与年龄无统计学意义上的相关性,而矢状位椎间盘平均信号和信号标准差与年龄之间仍有着较好的相关性(r分别为-0.50和-0.59,P0.001)。结论:在腰椎矢状位MR图像上测量椎间盘信号比横切面图像上测量椎间盘及髓核信号更能反映椎间盘退变程度。在上腰椎(L1-L4)中,横切面椎间盘的信号标准差和髓核的平均信号也能一定程度上反映腰椎退变程度;而在下腰椎(L4-S1)中,横切面各个信号量化指标与年龄并没有明显的相关性。
[Abstract]:Objective: to evaluate the feasibility of measuring lumbar disc and nucleus pulposus signals on transverse magnetic resonance imaging. Methods: MRI images of lumbar vertebrae in general population were collected and analyzed on T2 weighted images. The software Spine Explorer manually selected the area of the median sagittal disc and transverse disc and nucleus pulposus. The area of the upper nucleus pulposus on the transverse plane was 58% of that of the intervertebral disc. The L1-S1 intervertebral disc, the mean signal and signal standard deviation of the nucleus pulposus and the average signal of cerebrospinal fluid adjacent to the posterior were measured. The average signal and signal standard deviation of sagittal image disc and the average signal of cerebrospinal fluid near the back of the disc were measured. The signal measurements were corrected by the average signal of adjacent cerebrospinal fluid. The correlation between signal measurement value and age was calculated. Compare the transverse intervertebral disc, The correlation coefficient of nucleus pulposus signal and sagittal disc signal with age was evaluated to evaluate the effectiveness of various measurement methods for lumbar disc degeneration. Results: 66 general population samples, 33 males and 33 females, were included in the study. The mean age was 50.3 卤16.5 years old and 24-82 years old. A total of 330 signals on T2 weighted images of lumbar intervertebral disc were analyzed and measured. The mean signal measurement and signal standard deviation of sagittal intervertebral disc were only moderately reliable. The nuclear signal measurements showed that the mean signal and signal standard deviation of median sagittal intervertebral disc were significantly correlated with the age of ICC 0.80 and T _ 2W images, and the r values were -0.50 and -0.67g / P 0.001g, respectively, on the transverse plane, the mean signal and the signal standard deviation of the intervertebral disc in the median sagittal position were -0.50 and -0.67g P 0.001, respectively. The standard deviation of intervertebral disc signal was moderately negatively correlated with age, while the mean signal had no correlation with age (P < 0. 319), while the mean signal of nucleus pulposus showed moderate negative correlation with age, but there was no significant statistical correlation between signal standard deviation and age. When the lumbar vertebrae were divided into L1-L4 (L1-L4) and L4-S1 (L4-S1), the correlation between the signal intensity and age was analyzed. We found that the upper lumbar vertebrae showed the same results as above, and in the lower lumbar vertebrae, except for the lower lumbar vertebrae, the mean signal intensity of the nucleus pulposus showed a weaker correlation with age (P 0.05). There was no statistical correlation between the quantization index of the cross section signal and the age. But sagittal intervertebral disc mean signal and signal standard deviation still have good correlation with age, r is -0.50 and -0.59g P0.001 respectively. Conclusion: measuring intervertebral disc signal on sagittal Mr image is better than measuring intervertebral disc on transverse section image. And nucleus pulposus signal can better reflect the degree of disc degeneration. In L1-L4 of the upper lumbar vertebrae, The signal standard deviation of transverse intervertebral disc and the average signal of nucleus pulposus can also reflect the degree of lumbar degeneration to some extent, but in L4-S1 of lower lumbar vertebra, there is no obvious correlation between the quantification index of signal and age.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.53;R445.2

【相似文献】