肌肉功能磁共振成像对腰椎旁肌肉运动前后改变的评估

发布时间：2018-04-15 11:07

本文选题：椎旁肌 + 功能磁共振成像　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]通过对正常健康志愿者运动前后腰部背伸肌群(多裂肌、最长肌、髂肋肌)功能磁共振(functional magnetic resonance imaging,fMRI)成像研究,包括血氧依赖水平成像(blood oxygen level dependent,BOLD)、T2-mapping 等序列。观察运动前后腰部背伸肌群各肌肉R2*值及T2值变化特点,探讨运动前后腰部背伸肌群fMRI信号变化特点,为腰背部肌肉的影像学评估探索新的评估方法,也为肌肉运动训练提供理论依据和指导。[方法]本研究选取30名健康志愿者,其中男、女各15例,年龄在19～30岁,平均年龄(24.81 ±2.29)岁。采用PHILIPS Achieva 3.0TTx磁共振扫描仪,对健康志愿者运动前后分别行BOLD、T2-mapping扫描。并分别于L3、L4上缘层面采集运动前、后腰部背伸肌群(多裂肌、最长肌、髂肋肌)R2*值、T2值。运动方式采用简易罗马凳做上半身屈伸运动,整个运动过程有专人负责指导,以保证动作质量和动作数量一致。扫描所得图像在GE公司ADW4.4图像工作站上进行后处理分析,并在ADW4.4图像工作站上测量出运动前后L3、L4上缘层面各肌肉横截面积(Cross Section Area,CSA)、T2值、R2*值,并重建出BOLD伪彩图和T2-mapping伪彩图。应用SPSS22.0统计学软件对所有数据进行统计分析。[结果]腰部背伸肌群CSA随BMI增加而增加,其中男性肌肉总CSA大于女性(P0. 001)。运动后L3、L4上缘层面各肌肉CSA比运动前明显增加(P0. 001),其中L3上缘层面多裂肌运动前后CSA变化量较其它肌肉小(P0. 05),并且女性组L3上缘层面左右两侧髂肋肌运动前后CSA变化量差异显著(P0. 05),而男性组无此差异(P0. 05)。运动后L3、L4上缘层面各肌肉R2*值明显减低,但L3上缘水平多裂肌运动前后R2*值比较差异无统计学意义(P=0. 064)。并且女性组L3上缘层面左右两侧髂肋肌运动前后R2*值变化量差异有统计学意义(P0. 05),而男性组无此差异(P0. 05)。运动后L3、L4上缘层面各肌肉T2值比运动前显著增加(P0.001),其中L3上缘层面左右两侧多裂肌运动前后T2值变化量比较差异有统计学意义(P0.05),其余肌肉左右两侧对比,变化量无统计学意义。[结论]运动后,L3、L4上缘层面各肌肉运动前后CSA变化量与R2*值变化量一致,因此可以采用BOLD成像可以从血流灌注角度对肌肉运动前后进行评估,并可以根据局部肌肉血流灌注差异对运动过程中肌肉收缩程度进行评估。T2-mapping成像通过检测肌肉间隙内水分子变化可以对肌肉运动范围及程度进行评估。
[Abstract]:[objective] to study the functional magnetic resonance imagingfMRI imaging of the lumbar dorsal extensor muscle before and after exercise in healthy volunteers, including blood oxygen level independent T 2-mapping sequences.The changes of R2 * value and T2 value of each muscle of extensor dorsalis loin group before and after exercise were observed, and the changes of fMRI signal of extensor muscle group in lumbar dorsal muscle group before and after exercise were discussed, and a new evaluation method was explored for the imaging evaluation of lumbar dorsal muscles.Also provides the theoretical basis and the instruction for the muscle movement training.[methods] A total of 30 healthy volunteers, 15 males and 15 females, aged 19 to 30 years, with an average age of 24.81 卤2.29 years, were selected.PHILIPS Achieva 3.0TTx magnetic resonance scanner was used to scan the healthy volunteers before and after exercise.The posterior loin extensor muscle group (polyfissure muscle, longest muscle, iliac rib muscle) was collected at the upper margin of L3 / L4.The simple Roman bench is used to do the upper body flexion and extension, and the whole movement process is guided by a special person to ensure the quality and quantity of the movement is the same.The scanned images were processed and analyzed on the ADW4.4 image workstation of GE Company, and the cross-sectional area of each muscle on the upper edge of L3L4 before and after exercise was measured on the ADW4.4 image workstation. The T _ 2 value of the cross Section area was measured and the value of R2 * was reconstructed. The pseudochromatic BOLD and T2-mapping pseudo-color images were reconstructed.All the data were analyzed by SPSS22.0 software.[results] the CSA of extensor dorsalis loin group increased with the increase of BMI, and the total CSA of male muscle was greater than that of female group P0.001g.After exercise, the CSA of each muscle on the upper edge of L _ 3 and L _ 4 increased significantly compared with that before exercise.The changes of CSA in L3 upper margin were smaller than those in other muscles before and after exercise.In the female group, there was a significant difference in CSA between the left and right iliac rib muscles before and after exercise on the upper margin of L3, and there was a significant difference between the two groups (P 0. 0).There was no difference between male group and male group (P 0. 0).05.After exercise, the R2 * values of the muscles on the upper edge of L3 and L4 decreased significantly, but there was no significant difference in R2 * values between the two groups before and after exercise.064.In female group, there was significant difference in R2 * between the left and right iliac rib muscles on the upper margin of L3 before and after exercise (P 0. 0).There was no difference between male group and male group (P 0. 0).05.After exercise, the T _ 2 value of each muscle on the upper edge of L _ 3 / L _ 4 was significantly higher than that before and after exercise (P _ (0.001)). There was a significant difference in the changes of T _ 2 value between the left and right sides of the polyfissure muscle on the upper edge of L _ 3, but there was no significant difference in the changes between the left and right sides of the other muscles.[conclusion] the changes of CSA before and after exercise are consistent with that of R2 * on the upper edge of L3 / L4 after exercise. Therefore, BOLD imaging can be used to evaluate the muscle before and after exercise from the angle of blood perfusion.The range and degree of muscle movement can be evaluated by measuring the changes of water molecules in the muscle gap by using the T2-mapping imaging to evaluate the muscle contractility according to the difference of regional muscle perfusion.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R685

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