MR T2^(*)mapping成像技术定量评价腰椎小关节炎软骨损伤

Quantitative evaluation of lumbar facet arthritis-induced cartilage injury by MR T2^(*)mapping

背景:腰椎小关节炎是引起下腰痛的一个主要原因,目前主要依靠MRI进行初步定性诊断,但仍有一定漏诊、误诊的概率发生,因此MR T2^(*)mapping成像技术有望成为定量检查腰椎小关节炎软骨损伤的重要检测手段。目的:探讨MR T2^(*)mapping成像技术在定量分析腰椎小关节炎软骨损伤退变中的应用价值。方法:收集南京医科大学第四附属医院2020年4月至2022年3月门诊或住院合并下腰痛共110例患者,设为病例组;同时招募无症状志愿者80例,设为对照组。对所有纳入对象L1-S1的小关节行3.0 T MR扫描,获取T2^(*)mapping横断位图像和T2WI图像,分别对所有小关节软骨进行Weishaupt分级及T2^(*)值测量,收集数据并行统计学分析。不同小关节Weishaupt分级之间小关节软骨T2^(*)值比较采用单因素方差分析。结果与结论:①经统计分析发现,病例组腰椎小关节软骨T2^(*)值(17.6±1.5)ms明显较对照组(21.4±1.3)ms降低,差异有显著性意义(P<0.05);②在病例组中,随着腰椎小关节Weishaupt分级增加,小关节软骨T2^(*)值也呈逐渐下降趋势,且这种差异有显著性意义(P<0.05);③提示T2^(*)mapping能够较好地显示腰椎小关节软骨损伤的早期病理变化,腰椎小关节软骨的T2^(*)值能够定量评估腰椎小关节的软骨损伤程度;T2^(*)mapping成像技术能为影像学诊断腰椎小关节炎软骨早期损伤提供很好的理论依据,具有重要的临床应用价值。

BACKGROUND:Lumbar facet arthritis is one of the main causes of low back pain.At present,MRI is mainly used for preliminary diagnosis,and there is still a certain probability of missed diagnosis and misdiagnosis.Therefore,MR T2^(*)mapping imaging technology is expected to become an important means of quantitative detection of cartilage damage in lumbar facet arthritis.OBJECTIVE:To investigate the application value of MR T2^(*)mapping imaging technique in quantitative analysis of cartilage damage and degeneration of lumbar facet joint.METHODS:A total of 110 outpatient or inpatient patients with low back pain in Fourth Affiliated Hospital of Nanjing Medical University from April 2020 to March 2022 were collected and set as case group.At the same time,80 asymptomatic volunteers were recruited as the control group.T2^(*)mapping transectal images and T2WI images were obtained by 3.0T MR Scanning for the facet joints of all included subjects L1-S1.Weishaupt grading and T2^(*)value measurement were performed for all facet joint cartilage,and the data were collected for parallel statistical analysis.The comparison of T2^(*)values of facet joint cartilage between different articular Weishaupt grades was performed by one-way analysis of variance.RESULTS AND CONCLUSION:(1)Statistical analysis found that the T2^(*)value of lumbar facet joint cartilage in the case group(17.6±1.5)ms was significantly lower than that in the control group(21.4±1.3)ms(P<0.05).(2)In the case group,with the hierarchical increase of lumbar facet joint Weishaupt,the T2^(*)value of facet joint cartilage also showed a gradual decreasing trend,and the difference was statistically significant(P<0.05).(3)It is concluded that T2^(*)mapping can better display the early pathological changes of lumbar facet joint cartilage injury,and T2^(*)value of lumbar facet joint cartilage can quantitatively evaluate the degree of lumbar facet joint cartilage injury.T2^(*)mapping imaging technique can provide a good theoretical basis for the imaging diagnosis of the early cartilage injury induced by lumbar facet arthritis and has important clinical application value.