DR与MR全脊柱成像技术在退行性脊柱病诊断中的效果对比

Magnetic resonance imaging versus DR for whole spine imaging in patients with degenerative spinal disease

目的评估全脊柱数字化成像技术(DR)与MR成像质量,分析全脊柱站立位DR及仰卧位MR成像的测量的矢状面参数的差异及相关性。方法搜集2010年11月~2016年3月到我院就诊并诊断为退行性脊柱病的61名患者资料,年龄49.9±17.6岁,均行全脊柱站立位DR与仰卧位MR检查,分析全脊柱拼接的图像质量,在全脊柱DR侧位片、全脊柱MR正中矢状位图像测量颈椎前凸角(CL)、胸椎后凸角(TK)、腰椎前凸角(LL)、骶椎倾斜角(SS)、脊柱矢状位垂直轴(SVA)等参数,并利用配对T检验对比DR与MR测量值,并进行Pearson相关性分析。结果全脊柱DR与MR图像拼接质量优良率为100%,全脊柱DR及MR成像上测量CL、TK、LL、SS、SVA值分别为28.37±10.91o、29.98±8.96o、45.61±12.46o、34.38±9.05o、17.20±26.39 mm,及24.34±9.01o、21.22±8.13o、41.45±12.17o、37.45±8.19o、36.51±12.44 mm,DR与MR测量CL、TK、LL、SS、SVA值存在统计学差异(P值分别为0.000、0.000、0.000、0.001、0.007),相关系数r分别为0.69、0.68、0.72、0.51(P值分别为0.000、0.000、0.000、0.000、0.034)。结论站立位DR与仰卧位MR全脊柱成像图像质量良好,仰卧位MR图像测量的CL,TK,LL,SS,SVA等脊柱矢状面平衡参数与站立位DR相关,但存在明显区别,并不能代替站立位DR检查,须联合检查才能全面评估退行性脊柱病改变。

Objective To assess the quality of whole spine images obtained by DR and magnetic resonance imaging （MRI） and analyze the whole spinal imaging sagittal parameters for standing DR and supine MRI.Methods Sixty-one patients aged 49.9±17.6 years with degenerative spinal disease underwent both standing DR and supine MRI of the whole spine from November,2010 to March,2016.The image quality was retrospectively reviewed,and the cervical lordosis （CL）,thoracic kyphosis （TK）,lumbar lordosis （LL）,sacral slope （SS）,and sagittal vertical axis （SVA） were measured on the whole spinal lateral DR and middle sagittal MR images.Results Both the DR and MR whole spine images had a high quality （100%）.The CL,TK,LL,SS,and SVA measured were 28.37±10.91 o,29.98±8.96 o,45.61±12.46 o,34.38±9.05 o,and 17.20±26.39 mm on DR images and were24.34 ± 9.01 o,21.22 ± 8.13 o,41.45 ± 12.17 o,37.45 ± 8.19 o,and 36.51 ± 12.44 mm on MR images,respectively,showing significant differences in the measurements between the two modalities （P=0.000,0.000,0.000,0.001,and 0.007,respectively）.The correlation coefficient between DR and MR images for CL,TK,LL,SS,and SVA were 0.69,0.68,0.72,0.51,and 0.27 （P=0.000,0.000,0.000,0.000,and 0.034,respectively）.Conclusion Both standing DR and supine MR whole spine imaging can provide high-quality images.The CL,TK,LL,SS,and SVA measured on supine MR whole spine images are correlated with those on standing DR images but differ obviously.Supine MR imaging can not substitute standing DR examinations,and comprehensive assessment of degenerative spinal disease needs the combination of the two imaging techniques.