基于MRI定量评估终板变性与椎间盘退变的相关性分析

The correlation analysis of endplate degeneration and intervertebral disc degeneration quantitatively evaluated based on MRI

目的采用MRI技术即水脂分离技术(Dixon)评估终板的变性程度,并分析其与椎间盘退变的相关性。方法回顾性分析79例体检或腰痛患者行腰椎Dixon序列检查的图像,在水像图的后处理图像测量软骨终板的水含量,在T2WI图像上对椎间盘进行Pfirrmann(PM)分级,并测量终板凹角值。比较椎间盘退变不同PM分级各组间的差异,采用Spearman秩相关分析软骨终板水含量及终板凹角与椎间盘PM分级的相关性。结果不同椎间盘PM分级,软骨终板的水含量和终板凹角差异有统计学意义(P<0.05);每个软骨终板的含水量值及终板凹角与推间盘的PM分级相关,软骨终板含水量与椎间盘退变呈负相关(r>0.7),终板凹角与椎间盘退变呈中等正相关(Q0.5),软骨终板含水量与椎间盘PM分级相关性更高。结论软骨终板的含水量及终板凹角能够较好反映终板变性程度,与椎间盘退变密切相关。MRI测量软骨终板含水量及终板凹角可用于诊断腰椎间盘早期退变,对预防椎间盘退变具有重要的临床意义。

Objective To evaluate the degenerative degree of cartilage endplate and analyze the correlation between the degenerative degree of cartilage endplate and intervertebral disc degeneration by using a simple and convenient MRI technique,namely dixon,to measure the water content of cartilage endplate and the concave angle of cartilage endplate.Methods Seventy nine patients with physical examination or low back pain were evaluated retrospectively.The water content of cartilage endplate was measured on the post-processing image of water image.Pfirrmann(PM)grading of intervertebral disc was performed on T2WI image,and the concave angle of endplate was measured.Statistical methods single factor analysis of variance and multiple comparison were used to analyze whether there were statistically significant differences between and within groups with different PM grades of intervertebral disc degeneration.Spearman rank correlation analysis was used to study the correlation between the water content of cartilage endplate and the concave angle of endplate and the PM grade of intervertebral disc.Results There were significant differences in water content and concave angle of cartilage endplate among difierent PM grades(P<0.05);The water content and concave angle of each cartilage endplate were correlated with PM grade of intervertebral disc.The water content of cartilage endplate was significantly negatively correlated with intervertebral disc degeneration(r>0.7).The concave angle of endplate was moderately significantly positively correlated with intervertebral disc degeneration(r>0.5).The water content of cartilage endplate was more correlated with PM grade of intervertebral disc.Conclusion The water content and concave angle of cartilage endplate can well reflect the degree of endplate degeneration,which is closely related to intervertebral disc degeneration.MRI measurement of cartilage endplate water content and endplate concave angle can be used to diagnose early lumbar disc degeneration,which has important clinical significance for the prevention of lumbar disc degeneration,and provides new treatment direction and theoretical support for clinical lumbar disc degeneration and low back pain.