仰卧位及俯卧过屈位MRI对正常人多裂肌形态变化的研究

A study on the morphological changes of normal lumbar multifidus muscle in the dynamic evaluation with supine vs. prone flexion MRI

目的研究仰卧位及俯卧过屈位MRI对正常人多裂肌的形态变化。方法随机选取健康志愿者42例,男16例,女26例,年龄22~67岁,平均(39.1±12.2)岁;应用美国GEDISCOVERYMR7503.0T磁共振扫描仪,行仰卧位及俯卧过屈位配对检查,俯卧过屈位为患者俯卧于MR检查床上,腹部垫以表面呈弧形的软垫,高度为25cm,造成腰椎过屈状态。两种体位MRI检查要求扫描的腰椎间盘层面、层数及层厚一致;应用ImageJ软件进行图像分析,测量参数为:①多裂肌总横截面积(TCSA);②仰卧位与俯卧过屈位多裂肌TCSA差值(S-P)。结果各个节段多裂肌TCSA存在差异,自上至下逐渐增大;各个节段TCSA俯卧过屈位较TCSA仰卧位多裂肌形态减小,TCSA俯卧过屈位、TCSA仰卧位与俯卧过屈位差值自上至下也逐渐增大,差异具有统计学意义(P=0.000)。结论仰卧位及俯卧过屈位配对MRI检查动态评估正常人多裂肌形态变化对研究腰椎间盘突出症(LDH)的病因及发病机制具有重要意义。

Objective To investigate the morphological changes of normal lumbar multifidus muscle (LMM)in the dynamic evaluation with supine vs. prone flexion MRI. Methods 42 healthy volunteers (16 male and 26 female)between the ages of 22 and 67 years were enrolled in this study. All healthy volunteers underwent supine and prone flexion paired lumbar MRI, including sagittal T1WI, T2WI and axial T2WI sequences. LMM morphological parameters were obtained using the Image J software, including the total cross-sectional area (TCSA)and muscle morphological change between supine and prone flexion positions(S-P). Results TCSA of LMM increased gradually from L3/4 to L5/S1. TCSA with prone flexion position of LMM was less than TCSA with supine position from L3/4 to L5/S1(P = 0.000). Conclusions The morphological changes of normal lumbar multifidus muscle in the dynamic evaluation with supine vs. prone flexion MRI was important for exploring the etiology and pathogenesis of LDH.