青年人群慢性非特异性腰背痛的MRI研究

MRI Study on Chronic Non-Specific Low Back Pain in Young People

目的:采用SIEMENS Verio 3.0T磁共振成像(MRI)系统及Image J软件测量椎旁肌[多裂肌(multifidus muscle,MF);竖脊肌(erector spinae,ES)]影像学参数,包括横截面积(cross-sectional area,CSA)及脂肪浸润程度(fatty infiltration,FI),评价椎旁肌CSA和FI与慢性非特异性腰背痛的关系,并探讨不同性别人群椎旁肌影像学参数是否有差异。方法:选取2020年6月至2021年5月于我院行腰椎常规MRI T2WI(T2-weighted imaging)序列矢状位、T2WI轴位扫描的慢性非特异性腰背痛青年患者53例设为腰背痛组进行回顾性分析,其中男28例,女25例,所有患者均有明确腰背痛病史,病程超过12周,年龄18~40周岁,且排除其他特异性疾病;并选同时间段内于我院进行MRI相同序列检查的体检青年人员50例设为对照组,其中男25例,女25例。用Image J软件手动勾画L1~S1所有椎间盘中心层面椎旁肌感兴趣区域(ROI),并测量轴位图像椎旁肌CSA和FI。采用t检验比较腰背痛组与对照组之间及不同性别患者椎旁肌CSA、FI的差异。结果:腰背痛组与对照组多节段多裂肌、竖脊肌的CSA比较,差异均无统计学意义;腰背痛组患者多裂肌、竖脊肌FI均大于对照组(P<0.05)。男性组多裂肌、竖脊肌的CSA均大于女性组;多裂肌、竖脊肌FI均小于女性组,差异均有统计学意义(P<0.05)。结论:在青年人群中,慢性非特异性腰背痛患者的多裂肌、竖脊肌脂肪浸润程度较正常人群更加严重;青年男性多裂肌、竖脊肌的CSA大于青年女性、FI低于青年女性。

Objective:The imaging parameters[cross-sectional area(CSA)and fatty infiltration(FI)]of the paravertebral muscle[multifidus muscle(MF)and erector spinae(ES)]were measured by SIEMENS Verio 3.0T magnetic resonance imaging(MRI)system and Image J software to evaluate the relationship between CSA and FI of paravertebral muscle and chronic non-specific low back pain,and to explore whether the imaging parameters of paravertebral muscle were different among different genders.Methods:53 young patients with chronic non-specific low back pain who underwent conventional MRI T2WI(T2-weighted imaging)sequential sagittal and axial T2WI scanning in our hospital from June 2020 to May 2021 were selected as the low back pain group for retrospective analysis,including 28 males and 25 females.All the patients had a clear history of low back pain with a course of more than 12 weeks,aged 18-40 years,and other specific diseases were excluded.In addition,50 young people taking physical examination who underwent the same sequence MRI examination in our hospital during the same time period were selected as the control group,including 25 males and 25 females.Image J software was used to manually delineate the region of interest(ROI)for paravertebral muscle at the central level of discs L1~S1,and axial images of paravertebral muscle CSA and FI were measured.T-test was used to compare the differences of paravertebral muscle CSA and FI between the low back pain group and the control group and between different genders.Results:The CSA of multisegmental multifidus muscle and erector spinae of patients in the low back pain group had no statistical difference with those of the control group.The FI of multifidus muscle and erector spinae of patients in the low back pain group were higher than those of the control group(P<0.05).The CSA of multifidus muscle and erector spinae of the male group were higher than those of the female group.The FI of multifidus muscle and erector spinae of the male group were lower than those of the female group(P<0.05).Conclusion:In the young population,the degree of fatty infiltration of multifidus muscle and erector spinae in patients with chronic non-specific low back pain is more serious than that in healthy people.The CSA of multifidus muscle and erector spinae of young males are larger than those of young females,and the degree of fatty infiltration is lower than that of young females.