腰椎体退变与血液供应减少相关:基于一项双期增强CT研究

The correlation between the degeneration of the lumbar vertebrae and the decreased blood supply: a study based on the double phase contrast enhancement CT

目的：观察腰椎血液供应随老龄化发生的变化，分析其对腰椎退变的影响。方法横截面研究。研究对象为2012年1月～2012年12月间来我院体检的正常人，随机抽取180例不同年龄段对象。采用Siemens Somatom Definition AS 4D CT进行腰3椎平扫及双期增强扫描，三维薄层重建腰3椎体平扫及双期增强矢状面图像，选择正中矢状面为兴趣区层面，观察腰3椎体CT平扫骨质密度、增强动脉期和血池平衡期对比剂密度在不同性别间以及不同年龄组间的差异及相互间的关系。结果男性组腰3椎体CT增强动脉期对比剂密度与平扫骨质密度呈正直线相关（r＝0.420， P＜0.01），与年龄呈负相关性（r＝-0.674， P＜0.01），血池平衡期对比剂密度与年龄呈正相关性（r＝0.685，P＜0.01）。女性组腰3椎体CT增强动脉期对比剂密度与平扫骨质密度呈正直线相关（r＝0.296， P＜0.01），与年龄呈负相关性（r＝-0.448，P＜0.01），血池平衡期对比剂密度与年龄呈正相关性（r＝0.752，P＜0.01）。结论腰椎体退变与血液供应减少相关，两者互为影响、形成不良循环。

Objective To observe the changes of the blood supply of the lumbar vertebrae along with aging, and to analyze its effect on the degeneration of the lumbar vertebrae.Methods A corss-section study was performed.A total of 180 subjects with different age, who came to our hospital for health examination from January 2012 to December 2012, were randomly selected.The plain and double phase contrast enhancement scanning of the 3 rd lumbar vertebra was performed using a Siemens Somatom Definition AS 4D CT.All acquisition scanning data were reconstructed to 3-dimensional images.The median sagittal plain was taken as the region of interest.The bone mineral density of the 3rd lumbar vertebra using CT plain scanning was observed.The contrast agent density in arterial phase and blood pool balanced phase was also observed and compared between groups with different age and gender.Results In male group, the contrast agent density in enhancement CT arterial phase showed a positive linear correlation with the bone density of plain scanning （r=0.420, P〈0.01） and a negative correlation with age （r=-0.674, P〈0.01）.The contrast agent density in enhancement CT blood pool balanced phase showed a positive correlation with age （r=0.685, P〈0.01）. In female group, the contrast agent density in enhancement CT arterial phase showed a positive linear correlation with the bone density in plain scanning （r=0.296, P〈0.01） and a negative correlation with age （r=-0.448, P〈0.01）.The contrast agent density in enhancement CT blood pool balanced phase showed a positive correlation with age （r=0.752, P〈0.01）.Conclusion The degeneration of the lumbar vertebrae is correlated with decreased blood supply, showing an interacting relationship and resulting in a vicious circulation.