集成MRI对腰椎间盘退行性病变的诊断价值

The diagnostic value of integrated MRI for degenerative disc disease of the lumbar spine

目的 探索集成MRI(SyMRI,合成磁共振成像MAGiC序列)技术在腰椎间盘退行性病变中的诊断价值。方法 本研究为前瞻性研究。采用简单随机抽样法收集2020年3月—2022年5月接受腰椎MR检查的126例腰痛患者(共630个腰椎间盘),所有患者均行常规腰椎MR与MAGiC序列的数据采集。对所有腰椎间盘退变进行Pfirrmann分级,并分别对MAGiC序列测定的髓核纵向弛豫时间(T1值)、横向弛豫时间(T2值)和质子密度值(PD值)进行定量分析。采用Spearman分析评估MAGiC序列各定量值(T1、T2和PD值)与Pfirrmann各分级间的差异。采用Pearson相关性分析统计MAGiC序列各定量值与年龄、性别、BMI,以及功能障碍指数量表(ODI)、视觉模拟评分法(VAS)的相关性。采用ROC评估MAGiC序列各定量值对腰椎间盘退变的诊断效能。结果 Spearman分析结果显示,腰椎间盘髓核MAGiC序列(T1、T2和PD值)与Pfirrmann各分级具有显著相关性(r值分别为-0.493、-0.526、-0.556,P均<0.001),其中,T1值与PfirrmannⅠ~Ⅲ级呈显著负相关,T2值与PfirrmannⅠ~Ⅳ级呈显著负相关,PD值与PfirrmannⅠ~Ⅴ级呈显著负相关。Pearson相关性分析显示髓核的T1、T2、PD值均与年龄、腰痛相关评分量表(ODI、VAS)呈显著负相关(P均<0.05)。ROC曲线结果显示T1、T2、PD值定量诊断腰椎间盘退行性病变的AUC值分别为0.764、0.779和0.780。结论 SyMRI技术对腰椎间盘退行性病变的诊断效能较好,有望成为临床诊断和预测该病的影像标志物。

Objective To explore the diagnostic value of integrated MRI(SyMRI,synthetic magnetic resonance imaging)technology in degenerative changes of lumbar intervertebral discs.Methods This study was a prospective study.A total of 126 patients with low back pain(630 lumbar intervertebral discs)who underwent lumbar MR examination from March 2020 to May 2022 were included using simple random sampling.All patients underwent conventional lumbar MRI and data collection of MAGiC sequence.Pfirrmann grading was used to evaluate the degeneration of lumbar intervertebral discs,and quantitative analysis of longitudinal relaxation time(T1 value),transverse relaxation time(T2 value),and proton density value(PD value)under the MAGiC sequence was performed.Spearman analysis was used to assess the correlation between quantitative values(T1,T2,and PD values)of the MAGiC and Pfirrmann grades.Pearson correlation analysis was used to assess the correlation between MAGiC quantitative values of MAGiC and age,sex,BMI,as well as oswestry disability index(ODI)and visual analogue scale(VAS)scores.ROC analysis was used to evaluate the diagnostic efficacy of quantitative values of MAGiC sequence for disc degeneration.Results Spearman analysis showed that MAGiC T1 value of nucleus pulposus of lumbar intervertebral disc was significantly negatively correlated with PfirrmannⅠtoⅢgrade,T2 value was significantly negatively correlated with PfirrmannⅠtoⅣgrade,and PD value was significantly negatively correlated with PfirrmannⅠto V grade(r=-0.493,-0.526,-0.556,respectively).The differences were statistically significant(all P<0.001).Pearson correlation analysis showed significant negative correlations between T1,T2,PD values of nucleus pulposus and low back pain scores(ODI,VAS)(all P<0.05).ROC results showed that quantitative values of T1,T2,PD of lumbar intervertebral disc nucleus had good diagnostic efficacy in diagnosing disc degeneration,with AUC values of 0.764,0.779,and 0.780,respectively.Conclusion SyMRI technology can provide quantitative imaging biomarkers for the evaluation of lumbar intervertebral disc nucleus,providing reference for the diagnosis and treatment of lumbar disc degeneration.