青少年颈椎间盘早期退变应用磁共振T_(2)mapping成像技术的诊断价值分析

Value of magnetic resonance T_(2) mapping in the diagnosis of early cervical disc degeneration in adolescents

目的分析磁共振T_(2) mapping成像技术对青少年颈椎间盘早期退变的诊断价值。方法收集2019年11月至2020年9月在温州市中医院行颈椎MRI检查和T_(2) mapping扫描检查受检者的临床资料,按照每天低头时间(≥2 h)分为观察组和对照组,每组50例。比较两组受检者各节段颈椎间盘髓核对应的T_(2)值之间的差别;按照Pfirrmann标准对颈椎间盘进行分级,比较不同级别之间T_(2)值的差别,采用受试者工作特征曲线(ROC曲线)评估T_(2)值在青少年颈椎间盘早期退变中的诊断效能,计算对应的特异度、灵敏度和曲线下面积(AUC)。结果观察组各节段颈椎间盘测得的T_(2)值均高于对照组,差异均有统计学意义(C2-3、C3-4、C4-5、C5-6、C6-7项目组间t值依次为5.06、4.47、3.57、2.93、4.98,均P<0.05);观察组受检者,PfirrmannⅡ级例数最多,占42%(21/50);不同Pfirrmann分级下受检者颈椎间盘髓核T_(2)值,差异有统计学意义(与PfirrmannⅠ级比较,t=2.62,P=0.018;与PfirrmannⅡ级比较,t=2.12,P=0.045;与PfirrmannⅢ级比较,t=2.24,P=0.049。);Pfirrmann分级越高,受检者颈椎间盘髓核T_(2)值最低;ROC曲线显示T_(2)值在诊断椎间盘早期退变的灵敏度、特异度以及AUC分别为81.2%、79.8%和0.756。结论T_(2) mapping成像技术可通过定量分析颈椎间盘髓核T_(2)值,实现对青少年颈椎间盘早期退变的预估,具有较高的诊断价值,该成果具有一定创新性和科学性。

Objective To analyze the value of magnetic resonance T_(2) mapping in the diagnosis of early cervical disc degeneration in adolescents.Methods Patients who underwent cervical MRI examination and magnetic resonance T_(2) mapping in Wenzhou Hospital of Traditional Chinese Medicine between November 2019 and September 2020 were included in this study.They were divided into observation and control groups(n=50 per group)according to the time of lowering their heads(≥2 hours)every day.The T_(2) values corresponding to the nucleus pulposus of cervical intervertebral disc in each segment was compared between the two groups.Cervical disk degeneration was graded using the Pfirrmann classification.T_(2) value was compared between different Pfirrmann disc grades.The efficacy of T_(2) value in the diagnosis of early cervical disc degeneration in adolescents was evaluated using the receiver operating characteristic curve.The specificity and sensitivity of T_(2) value in the diagnosis of early cervical disc degeneration in adolescents and the area under the receiver operating characteristic curve were calculated.Results T_(2) value measured in each cervical intervertebral disc segment in the observation group was significantly greater than that in the control group(t=5.06,4.47,3.57,2.93,4.98 for C2-3,C3-4,C4-5,C5-6,C6-7 segments,all P<0.05).In the observation group,the number of patients with Pfirrmann grade II cervical intervertebral disc degeneration was highest,accounting for 42%(21/50).There was a significant difference in cervical intervertebral disc segment T_(2) value between different Pfirrmann disc grades(t=2.62,P=0.018,vs.Pfirrmann disc grade I;t=2.12,P=0.045,vs.Pfirrmann disc grade II;t=2.24,P=0.049,vs.Pfirrmann disc grade III).The higher Pfirrmann grade,the lower T_(2) value of cervical intervertebral disc nucleus pulposus.The receiver operating characteristic curve showed that the sensitivity and specificity of T_(2) value in the diagnosis of early cervical disc degeneration and the area under the receiver operating characteristic curve were 81.2%,79.8%and 0.756,respectively.Conclusion T_(2) mapping imaging technology can predict early cervical intervertebral disc degeneration in adolescents by quantitatively analyzing the T_(2) value of cervical intervertebral disc nucleus pulposus and has a high value in the diagnosis of cervical intervertebral disc degeneration.This achievement is of innovation and science.