动态对比增强磁共振成像评价腰椎间盘血供的价值

Degenerative changes of lumbar spine:dynamic contrast-enhanced MRI profiles related to age and K-trans

[目的]通过动态对比增强磁共振成像对评价不同年龄段椎间盘血供情况,探讨炎性因子进入椎间盘的方式。[方法]采用GESIGNAEXCITE 1.5T超导型MR成像仪及脊柱表面线圈,扫描采用快速自旋回波脉冲序列及DCE-MR扫描序列。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100例500个腰椎间盘进行分级,并对跨膜转运常数进行测量,得到K-trans值。[结果]腰椎间盘随年龄增长迅速退变,椎间盘评级Ⅰ级到Ⅳ级时,随着腰椎间盘退变等级的增加,K-trans值与之正相关(P<0.05);在相同评级时,年龄与K-trans值正相关,在Ⅲ级时,相关度最高。[结论]年龄与椎间盘退变存在明显的相关性,年龄越大退变越严重。微血管的浸润与年龄及腰椎间盘退变等级均具有一定的相关性。

[Objective] To evaluate the blood supply in lumbar intervertebral disc in different ages by using dynamic contrast- enhanced magnetic resonance imaging and explore the inflammatory factors influencing the intervertebral disc. [ Methods ] Conven- tional scan and DCE - MRI were carried out simultaneously by using GESIGNAEXCITE 1.5T MR. According to Pfirrmarm grading standard, 100 cases （500 lumbar intervertebral discs） who met the inclusion criteria for classification were scanned in sagittal T2WI with blind method, and to measure the K - trans value. [ Results ] Lumbar disc degenerated rapidly along with the age growth. In Pfirrmmm grade I - IV, with the increase of lumbar disc degeneration , K - trans values showed positive correlation （P 〈 0. 05） . In the same degeneration grade, K - trans value was positively correlated to age, and the most relevant was found in Pfirrmann Ⅲ. [ Concluion] Intervertebral disc degeneration is obviously related to age. The older the patient is, the more serious the degeneration is. K - trans value also has positive correlations to age and lumbar disc degeneration grade.