腰椎间盘退变软骨下骨及软骨终板灌注的DCE-MRI定量研究

发布时间：2018-06-26 12:29

本文选题：椎体软骨下骨 + 软骨终板　；参考：《临床放射学杂志》2017年05期

【摘要】：目的采用基于Extended Tofts linear模型动态对比增强MRI(DCE-MRI)定量研究椎间盘退变椎体软骨下骨(VSB)、软骨终板(CEP)的灌注。方法 18例受检者分别行腰椎常规检查及DCE-MRI。记录椎体头、尾侧VSB、CEP感兴趣区灌注参数Ktrans、Kep、Ve值。在腰椎正中矢状位T2WI确定椎间盘Pfirrmann分级。采用单因素方差分析(One-way ANOVA)与Newman-Keuls多重比较检验比较不同分级DCE-MRI各灌注参数值差异,以P0.05为差异具有统计学意义。结果共纳入研究90个椎间盘。Pfirrmann 1级5个,占5.56%;2级27个,占30.00%;3级21个,占23.33%;4级32个,占35.56%;5级5个,占5.56%。头、尾侧VSB及头、尾侧CEP灌注参数从1~2级先上升,2~3级后下降,4~5级再上升后下降。不同Pfirrmann分级头侧VSB Ktrans值、Kep值、尾侧VSB Kep值、头侧CEP Kep值具有统计学意义(F值分别为2.701、5.036、2.724、2.714,P值均0.05)。其中Pfirrmann 1级与2级、1级与4级、2级与3级、3级与4级头侧VSB Kep值、Pfirrmann 1级与4级尾侧VSB Kep值及Pfirrmann 2级与3级头侧CEP Kep值差异具有统计学意义(q值分别为4.560、5.059、3.425、4.305、3.996、4.256,P值均0.05),余两组间VSB、CEP灌注参数值差异均无统计学意义(P值均0.05)。结论 DCE-MRI定量技术显示在椎间盘退变中,VSB及CEP灌注在Pfirrmann 2级升高,3级降低,4级升高,最后在5级降低。
[Abstract]:Objective to study the perfusion of subchondral bone (VSB) and endplate (CEP) of degenerative vertebral body of intervertebral disc by dynamic contrast enhanced MRI (DCE-MRI) based on extended Tofts linear model. Methods Lumbar vertebrae routine examination and DCE-MRI were performed in 18 patients. The perfusion parameters of the vertebral head and caudal VSB-CEP were recorded. The Pfirrmann grade of intervertebral disc was determined on T _ 2 WI in the median sagittal position of lumbar vertebrae. One-way ANOVA (One-way ANOVA) and Newman-Keuls multiple comparison test were used to compare the perfusion parameters of DCE-MRI with different grades (P0.05). Results A total of 90 intervertebral discs. Pfirrmann grade 1 was 5, accounting for 5. 56 and 2 grades 27, 30.003 and 21, accounting for 23. 3333 and 4 grades 32, 35. 56 and 5. 56. The perfusion parameters of head, caudal VSB and head, caudal CEP increased first from 1 to 2, and then decreased from grade 2 to grade 3, and then increased to grade 4 and then decreased. There were significant differences in VSB Ktrans value, tail VSB Kep value and cephalic CEP Kep value between different Pfirrmann grades (F = 2.701 / 5.036 / 2.724 / 2.714 / P, respectively). The VSB Kep values of Pfirrmann grade 1 and grade 2, grade 4, grade 2 and grade 3, grade 3 and grade 4 are significantly different from those of Pfirrmann class 1 and grade 4, and the CEP Kep values of Pfirrmann class 2 and grade 3 have statistical significance (Q = 4.5605.059 3.4254.3053.9964.256P, respectively), and the difference of CEP Kep between Pfirrmann class 2 and grade 3 is significant (Q = 4.5605.059.3.4254.3053.9964.256P, respectively). There was no significant difference in CEP perfusion parameters between the two groups (P 0.05). Conclusion the quantitative technique of DCE-MRI showed that VSB and CEP perfused in the degenerative intervertebral disc were increased in Pfirrmann grade 2, decreased in grade 3 and decreased in grade 4, and finally in grade 5.
【作者单位】：武汉大学人民医院放射科;医学信息分析及肿瘤诊疗湖北省重点实验室;中南民族大学生物医学工程学院;GE中国医疗集团;
【基金】：医学信息分析及肿瘤诊疗湖北省重点实验室开放课题资助项目(编号:PJS140011511)
【分类号】：R445.2;R681.5

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