磁共振T2 Mapping成像对颈椎间盘退变的初步研究

发布时间：2018-03-23 08:23

本文选题：磁共振成像　切入点：颈椎　出处：《南方医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：第一章颈椎间盘退变与Miyazaki分级研究目的通过分析颈椎间盘节段、受检者性别和年龄与Miyazaki分级的关系,探讨颈椎间盘退变相关的生理因素,为之后定量分析奠定基础。材料和方法收集2016年6月～10月来我院行颈椎MRI检查患者82例。使用GE Signa HDXT1.5T超导MRI、CTL脊柱相控阵线圈进行颈椎扫描,FSE序列采集常规矢状位T2WI图像,并依据颈椎间盘Miyazaki分级标准进行分级。应用SPSS 22.0软件,对颈椎间盘Miyazaki分级与颈椎间盘节段、受检者性别及年龄分别进行统计学分析。结果共纳入410个颈椎间盘节段进行研究,Miyazaki Ⅰ级椎间盘18个、Ⅱ级94个、Ⅲ级204个、Ⅳ级83个、V级11个。不同颈椎间盘节段Miyazaki等级有显著性差异(P=0.003)。不同性别颈椎间盘Miyazaki等级未见显著性差异(P=0.172)。除Ⅳ和Ⅴ级外,不同颈椎间盘Miyazaki等级受检者年龄有显著性差异,且年龄与颈椎间盘Miyazaki等级呈正相关(rs=0.554,P=0.000)。结论Miyazaki分级系统作为一种专用于评价颈椎间盘退变的影像学分级系统,对颈椎间盘退变的评估具有一定价值。但该分级系统是基于信号强度为主的主观视觉评估系统,且不能尽早的发现并量化椎间盘的退变。第二章颈椎间盘退变的T2 Mapping成像研究目的应用GE 1.5T磁共振T2 mapping定量成像检查技术对参照Miyazaki标准进行分级的颈椎间盘的髓核进行测量、比较,以此评价T2 mapping定量成像检查技术对颈椎间盘退变的诊断价值,为影像学诊断颈椎间盘退变及准确量化分级提供依据,为临床确诊颈椎间盘退变提供参考。材料和方法收集2016年6月～10月临床确诊或怀疑颈椎病而来我院行颈椎MRI检查患者共81例。检查时间均为早上7:30-9:00。使用GE Signa HDXT 1.5T超导MRI、CTL脊柱相控阵线圈进行颈椎扫描。扫描序列有轴位T2WI,矢状位T1WI、T2WI、T2压脂以及T2 mapping。以T2WI正中矢状位图像为基础依据Miyazaki分级系统进行椎间盘分级。将T2 mapping序列扫描所得原始数据传入GE AW 4.6后处理工作站,打开Functool/T2 mapping软件,设置伪彩图上彩色标尺的T2值范围,经过软件对数据的重建和分析得到T2弛豫时间伪彩图。最后选取T2弛豫时间伪彩图正中矢状面对应的T2 mapping原始数据图层面作为感兴趣层面,结合伪彩图的显示在C2～C7各椎间盘髓核区自前向后分5等份为5个感兴趣区域(regions of interest,ROls),面积均约5mm2。分别测量各感兴趣区T2值3次,最后取平均值。髓核T2值来源于5个感兴趣区域T2值的平均值。采用SPSS 22.0软件,对不同的Miyazaki等级、相同Miyazaki等级不同区域,不同椎间盘节段、相同节段不同区域,受检者性别及年龄组(≤35,35～50,50)分别与椎间盘髓核的T2弛豫时间值进行统计学分析。结果81位受检者共405个颈椎间盘,Miyazaki分级Ⅰ级椎间盘15个,Ⅱ级91个,Ⅲ级216个,Ⅳ级75个,V级8个。除去Ⅴ级椎间盘,本研究纳入颈椎间盘共397个;不同Miyazaki分级的颈椎间盘髓核T2值差异有统计学意义(F=10.150,P=0.000)。Dnnett T3法两两比较,各级间差异也有统计学意义(P=0.000)。且颈椎间盘髓核T2值与Miyazaki分级呈显著负相关(rs=-0.833,P=0.000);颈椎间盘相同Miyazaki等级不同感兴趣区域的T2值差异有统计学意义(P=0.000);不同节段的颈椎间盘髓核T2值差异有统计学意义(P=0.000)。且颈椎间盘髓核T2值与节段呈弱正相关(rs=0.363,P=0.000);颈椎间盘相同节段不同感兴趣区域的T2值差异有统计学意义(P=0.000);在颈椎间盘各节段,性别与髓核T2值差异均无统计学意义;年龄组与颈椎间盘髓核的T2值差异有统计学意义(F=10.890,P=0.000)。Dnnett T3法两两比较,各组间差异也有统计学意义(P=0.000)。且年龄与颈椎间盘髓核的T2值呈中度负相关(rs=-0.550,P=0.000)。结论T2 mapping成像可以作为一种定量分析的手段,用以评估颈椎间盘的退变,使客观、无创性的量化评价活体椎间盘的生理状态及退变程度成为可能,为早期诊断和早期预防治疗颈椎间盘退变提供依据。
[Abstract]:The first chapter study on the classification of cervical intervertebral disc degeneration and Miyazaki objective through the analysis of cervical intervertebral disc segments, the relationship between gender and age and Miyazaki grade subjects of cervical disc degeneration associated physiological factors, to lay the foundation of quantitative analysis. Materials and methods from June 2016 to October in our hospital 82 patients with cervical MRI examination the use of GE Signa HDXT1.5T. MRI CTL superconducting, phased array coil for cervical spine FSE scan sequence acquisition routine sagittal T2WI images, and on the basis of the Miyazaki standard classification of cervical intervertebral disc were graded. The application of SPSS 22 software, Miyazaki grading of intervertebral disc and cervical intervertebral disc segments, subjects of sex and age were analyzed statistically. Results a total of 410 cervical intervertebral disc segments of Miyazaki grade disc 18, grade 94, grade 204, grade 83, V grade 11. Different cervical intervertebral disc segments Miy The azaki level had significant difference (P=0.003). No significant difference Miyazaki grade gender cervical (P=0.172). In addition to IV and V grade, different grades of cervical intervertebral disc Miyazaki subjects age has significant differences, and the age and cervical intervertebral disc Miyazaki level was positively correlated (rs=0.554, P=0.000) conclusion. The Miyazaki grading system as a dedicated to the evaluation of cervical disc degeneration imaging classification system, and has a certain value in evaluation of cervical disc degeneration. But the grading system is mainly based on the signal intensity of the subjective visual evaluation system, and not as soon as possible and to quantify the degeneration of intervertebral disc. The second chapter cervical intervertebral disc degeneration the T2 Mapping imaging objective GE 1.5T magnetic resonance imaging technology T2 mapping quantitative classification of cervical intervertebral disc nucleus pulposus of referring to Miyazaki standard measurement, comparison, in order to evaluate T2 mapping The value of quantitative imaging technique in the diagnosis of cervical intervertebral disc degeneration, diagnosis of cervical disc degeneration and accurate quantitative classification to provide the basis for imaging, provides the reference for the clinical diagnosis of cervical intervertebral disc degeneration. Materials and methods from June 2016 to October diagnosed or suspected of cervical spondylosis and cervical MRI examination in our hospital patients in 81 cases. Check the time for the use of GE Signa HDXT 1.5T at 7:30-9:00. MRI CTL superconducting, phased array coil for cervical spine CT scan. The sequence of axial T2WI, sagittal T1WI, T2WI, T2 and T2 mapping. with T2WI fat midsagittal images based on Miyazaki classification system for disc T2 classification. Mapping sequences derived from the original data into GE AW 4.6 postprocessing workstation, open the Functool/T2 mapping software, set the pseudo color color scale range of the T2 value, after the data and reconstruction software Analysis of T2 relaxation time of the pseudo color map. Finally select the T2 relaxation time of pseudo color image median sagittal face should be T2 mapping original data map level as the interest level, combined with the pseudo color display in C2 ~ C7 of the intervertebral disc nucleus area from front to back is divided into 5 equal parts into 5 regions of interest (regions of interest, ROls, 5mm2.) were measured in each area were about 3 times the value of T2 in the region, and finally averaged. The average T2 value of NP from 5 regions of interest T2 value. Using SPSS 22 software for different Miyazaki levels, different areas of the same grade of Miyazaki, with the disc section section of the same segment in different regions, the subjects of sex and age group (35,35 ~ 50,50) were statistically analyzed respectively with intervertebral disc nucleus T2 relaxation time values. Results 81 subjects were 405 cervical intervertebral disc Miyazaki, disc 15 grade I, grade II in 91. Grade 216, class IV 75, V grade 8. Remove the V-grade disc, this study included a total of 397 cervical intervertebral disc; cervical Miyazaki stages of nucleus pulposus T2 value were statistically significant (F=10.150, P=0.000).Dnnett T3 22, there were significant differences between all levels (P=0.000) and cervical. Disc nucleus T2 value was negatively correlated with the Miyazaki grade (rs=-0.833, P=0.000); the different grade of cervical intervertebral disc the same Miyazaki region of interest T2 value difference was statistically significant (P=0.000); cervical segment of the nucleus pulposus of T2 value were statistically significant (P=. 0) and cervical intervertebral disc nuclear T2 values showed a weak positive correlation with segments (rs=0.363, P=0.000); cervical intervertebral disc of the same segment in different regions of interest T2 value difference was statistically significant (P=0.000); in the cervical intervertebral disc segments, gender and nucleus T2 values showed no statistically significant differences in age group; and cervical intervertebral disc T2 core values The difference was statistically significant (F=10.890, P=0.000).Dnnett T3 22, and the difference between groups was statistically significant (P=0.000). And the age and cervical intervertebral disc nucleus T2 showed a moderate negative correlation (rs=-0.550, P=0.000). Conclusion T2 mapping imaging can be used as a quantitative analysis method, to evaluate the cervical vertebra intervertebral disc degeneration, to make an objective, noninvasive quantitative evaluation in vivo intervertebral disc degeneration and physiological state as possible, for the early diagnosis and early prevention and treatment of cervical intervertebral disc degeneration and to provide the basis.

【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.5;R445.2

【参考文献】