腰椎间盘退变患者的髓核ADC值与解剖位置关系的初步研究

Assessment of the apparent diffusion coeficient values and anatomic level in patients of degenerated intervertebral lumbar disk

目的：应用DWI探讨腰椎退行性变患者椎间盘髓核ADC值是否与椎间盘的解剖层面相关.方法：对72例腰椎间盘退变患者行腰椎MRI普通序列和DWI扫描,并测量L1～2至L5～S1椎间盘髓核的ADC值,分析椎间盘髓核平均ADC值与解剖层面之间的相关性.结果：L1～2至L5～S1椎间盘平均ADC值分别为（1.47±0.33）x10-3 mm2/s、（1.47±0.31）x10-3 mm2/s、（1.42±0.34）x10-3 mm2/s、（1.33±0.35）x10-3mm2/s、（1.32±0.38）x10-3mm2/s.从L1～2至L5～S1随着椎间盘位置的下移,ADC值有下降趋势.椎间盘的平均ADC值仅在L1～2与L4～5、L1～2与L5～S1、L2～3与L4～5、L2～与L5～S1之间差异有统计学意义（P＜0.05）.结论：椎间盘髓核的ADC值能反映腰椎间盘退行性改变,且L4～5与L5～S1椎间盘ADC值较L1～2与L2～3低,差异有统计学意义.

Objective：To discuss the relationship between the apparent diffusion coeficient （ADC） values of nucleus pulposus and anatomic level of the disk using diffusion-weighted imaging （DWI）. Methods：Conventional MRI sequence and DWI of lumbar spine was performed in 72 patients with degenerated lumbar disks. ADC values of each disk （L1-2 -L5-S1 ） were measured. The relationship between the mean ADC values and the anatomic level of the disk were analyzed. Results：The mean ADC values of L1-2-L5-S1disks were （1.47±0.33）x10-3 mm2/s、（1.47±0.31）x10-3 mm2/s、（1.42±0.34）x10-3 mm2/s、（1.33±0.35）x10-3mm2/s、（1.32±0.38）x10-3mm2/s and （1.32±0.38） X 10 3mm2/s respectively and decreased from L2-3 toL5-S1. There were significant differences of the mean ADC values at different anatomical levels such as L1-2 vs L4-s, L1-2 vs L5-S1 , L2-3 vs L4-5, L2-3 vsL5-S1 （P〈0.05）. Conclusion： The mean ADC values can reflect degeneration of intervertebral lumbar disks, furthermore,with the anatomic level decreasing, the mean ADC values decrease.