3.0T MRI弥散加权成像评价腰椎间盘退变原因的价值

3.0 T magnetic resonance imaging diffusion-weighted imaging in evaluation of the reasons for lumbar disc degeneration

背景:MR弥散加权成像对水分子的扩散运动敏感,能早期了解椎间盘纤维环和髓核的含水量改变,从而明确其退变程度。目的:通过对109例腰椎间盘的弥散加权成像进行前瞻性研究,旨在提高应用MRI中弥散加权成像序列对椎间盘退变程度和早期变性诊断的认识。方法:采用Siemens Verio 3.0T超导磁共振仪。常规平扫包括矢状位T1WI序列及T2WI抑脂序列;弥散加权成像采用SE-EPI序列行矢状位扫描,取b值为800s/mm2,层厚、间距和显示野同T2WI抑脂序列扫描。根据Pfirrmann等的椎间盘退变分级标准,采用盲法在矢状位T2WI上对符合纳入标准的109例545个腰椎间盘进行分级。将弥散加权成像数据传至工作站,并对表观扩散系数图像进行测量,得到表观扩散系数值。分别画出L1/2-L5/S1椎间盘的感兴趣区,记录数据。结果与结论:年龄与椎间盘退变分级存在明显相关性,年龄越大高级别数量越多。椎间盘表观扩散系数值影响因素分析:男性与女性各椎间盘表观扩散系数值之间差异无显著性意义(P>0.05)。L1-S1各椎间盘年龄与表观扩散系数值之间存在负相关(P<0.05);椎间盘评级与表观扩散系数值之间存在负相关(P<0.05)。提示通过对表观扩散系数值的研究,弥散加权成像将会成为椎间盘退行性变诊断、特别是椎间盘早期退变、无创评价治疗效果及预后判断的重要技术手段。

BACKGROUND：Diffusion weighted imaging of MRI is sensitive for water molecule diffusion motion, can make us early understand the water content in annulus fibrosus and nucleus pulposus, so as to clarify its degeneration. OBJECTIVE：To elevate the knowledge of disc degeneration and early diagnosis using diffusion-weighted imaging of MRI by prospectively studying lumbar disc diffusion-weighted imaging in 109 patients. METHODS：Siemens Verio 3.0 T superconducting MRI was used. Conventional scan included sagittal T1WI and T2WI fat suppression sequence. Diffusion-weighted imaging used spin-echo echo planar imaging sequence sagittal scanning, taking b value of 800 s/mm2. Thickness, spacing, and field-of-view scan sequence was the same as fat suppression T2WI. According to Pfirrmann grading standard, the blind method was used in sagittal T2WI on 109 cases who met the inclusion criteria for classification of 545 lumbar intervertebral discs. The diffusion-weighted imaging data were uploaded to the station. Apparent diffusion coefficient images were measured, and the apparent diffusion coefficient values were obtained. Regions of interest of L1/2-L5/S1 discs＆amp;nbsp;were drawn, and the data were recorded. RESULTS AND CONCLUSION：Age was obviously correlated with intervertebral disc degeneration grading. The older age indicated more number of higher grades. Influencing factors for apparent diffusion coefficient：no significant difference in apparent diffusion coefficient was detected between males and females （P〉0.05）. L1-S1 intervertebral disc age was negatively associated with apparent diffusion coefficient values （P〈0.05）. Disc rating was negatively correlated with apparent diffusion coefficient values （P〈0.05）. Results indicated that diffusion-weighted imaging wil become an important technical mean for disc degeneration diagnosis, especial y early disc degeneration, noninvasive evaluation of treatment and prognosis by studying apparent diffusion coefficient values.