颈椎椎旁肌脂肪浸润与颈痛相关性的MRI分析

MRI Study on the correlation between fat infiltration in cervical ParasPinal muscles and neck Pain

目的 探讨应用MRI定量非对称回波最小二乘估算法迭代水脂分离(IDEAL-IQ)技术定量评估颈椎椎旁肌脂肪分数(FF)并评价其与颈痛的相关关系。方法 选取因颈部疼痛3个月以上的就诊患者75例,接受颈椎MRI检查。测量每例患者上颈部(C2~3椎间盘中心水平)及下颈部(C6~7椎间盘中心水平)FF,并进行临床评分,将患者的FF分别与年龄、BMI、椎间盘平均退行性变等级、相应临床评分做相关性分析。结果 FF与颈痛临床数字评估数值(NRS)呈明显正相关(C2~3,P<0.001;C6~7,P<0.001)。在C6~7椎间盘中心水平,FF与颈功能障碍指数(NDI)呈正相关(r=0.475,P<0.001)。C2~3椎间盘中心水平FF与年龄、BMI、椎间盘退行性变等级差异无统计学意义(P>0.05);C6~7椎间盘中心水平FF与BMI、椎间盘退行性变等级差异无统计学意义(P>0.05),与年龄线性相关性显著(P<0.05),呈正相关(r=0.324)。结论 颈椎椎旁肌的脂肪含量与颈痛有明显的关系。C6~7椎间盘中心水平椎旁肌的脂肪含量与颈功能部分丧失有关。

Objective The purpose of this study was to quantitatively evaluate the correlation between cervical paraspinal muscle fat fraction and neck pain using the MRI IDEAL-IQ sequence.Methods Outpatients with neck pain for more than 3 months were collected.All of these patients received MRI scanning of the cervical spine.The IDEAL-IQ sequence was used to measure the fat fraction of the cervical paraspinal muscle in the upper(C2-3 disc center level)and lower(C6-7 disc center level)neck of each patient.Clinical scores were given to the patients.The correlation between the cervical paraspinal muscle fat fraction and age,BMI,disc degeneration grade,clinical score were analyzed.Results Fat fraction in cervical paraspinal muscles were positively correlated with neck pain(NRS)scores at both levels(C2-3,P<0.001.C6-7,P<0.001).At the C6-7 intervertebral level,fat infiltration in the cervical paraspinal muscles were closely related to neck disability index(NDI)(r=0.475,P<0.001).There was no significant correlation between cervical paraspinal muscle fat fraction and age,BMI and disc degeneration grade at the C2-3 intervertebral level(P>0.05).There was no significant correlation between cervical paraspinal muscle fat fraction and BMI,disc degeneration grade at the C6-7 intervertebral level(P>0.05).At the C6-7 paraspinal level,the cervical paraspinal muscle fat fraction was negatively correlated with age(r=0.324,P=0.005).Conclusions Increased fat infiltration in the cervical paraspinal muscles was significantly associated with higher neck pain.Fat infiltration in the lower cervical paraspinal muscles may be associated with partial loss of cervical function.