MRS在评估退行性脊柱畸形患者椎旁多裂肌脂肪浸润度价值的研究

Magnetic Resonance Spectroscopy Evaluate Fat Infiltrations of Multifidus Musclesandassociation with Degenerative Spinal Deformity

目的 应用单体素磁共振波谱成像(SMRS)技术定量分析退行性脊柱畸形(DSD)患者多裂肌脂肪相对含量,探讨在腰椎功能评价中的价值。方法 搜集本院2019年3月至2021年1月收治的38例DSD患者(畸形组),32名健康志愿者(对照组)进行对比。所有被试均行SMRS序列扫描,分析L_(4/5)椎间盘双侧多裂肌平均相对脂肪含量(Fat%)。疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和Roland-Morris腰痛功能障碍评分(RMDQ)作为评估被试的腰椎功能状况的临床指标。对比两组被试L_(4/5)SMRS脂肪相对含量差异性,并分析与VAS、ODI及RMDQ的相关性。结果 畸形组多裂肌平均Fat%为(62.03±16.91)%,对照组为(43.44±17.46)%,有显著性差异(P<0.05),畸形组VAS、ODI和RMDQ评分显著高于对照组(P<0.05)。多裂肌平均Fat%与ODI、RMDQ评分均呈正相关(P=0.000,0.001,r=0.417,0.394),而与VAS评分无明显相关性(P=0.045,r=0.240)。结论 SMRS能定量反映DSD患者多裂肌脂肪浸润度,为患者腰椎功能评价提供客观依据。

Objective To analyze fat content of the multifidus muscle using MR spectroscopy in degenerative spinal deformity(DSD) and control groups and to discuss the value in the evaluation of lumbar physical functioning.Methods The study was approved by the responsible institutional review board.Informed consent was obtained from each volunteer.We evaluated 38 patients in DSD group and 32 healthy persons(control group).Percentage of fat content of the lumbar multifidus muscle at L_(4) to L_(5) disk level were measure by Single-voxel proton MR spectroscopy.The Visual Analog Scale,the Oswestry Disability Index(ODI) and the Roland-Morris Disability Questionnaire(RMDQQ) were used to evaluate lumbar physical function.Results The mean percentage fat content of the multifidus muscles was(62.03±16.91)% in DSD group and(43.44±17.46)% in control group(P<0.05).VAS,ODI and RMDQ scores in DSD group were significantly higher than those in control group(P< 0.05).According to the correlation analysis,the fat content of the multifidus muscle was positively correlated with the ODI(P=0.000,r=0.417)as well as with the RMDQ(P=0.001,r= 0.394),but had no significant correlation with VAS(P=0.045,r=0.240).Conclusion SMRS can quantitatively reflect fat infiltrations of multifidus muscle in patients with degenerative spinal deformities,and provide objective basis for patient’s lumbar physical function.