MRI在椎间盘退变导致的椎间盘源性下腰痛诊断与评估中的应用进展

Advances in the application of MRI in the diagnosis and evaluation of discogenic low back pain caused by intervertebral disc degeneration

下腰痛是常见的健康问题,对个人和社会造成了沉重的负担,椎间盘退变引起的椎间盘源性下腰痛是最常见的病因之一。MR技术常用于椎间盘退变及其并发症的常规诊断。近年来,随着人工智能和定量技术的发展,基于T2WI的纹理分析以及各种MR定量技术逐渐成为椎间盘源性下腰痛早期诊断、致痛性椎间盘识别以及治疗方案决策、椎间盘再生医学疗效评估的重要工具。多模态影像融合、人工智能辅助诊断等有望在椎间盘源性下腰痛的诊断和治疗、椎间盘新兴治疗的发展中发挥不可替代的作用,致痛性椎间盘的高特异性识别序列如CEST、MRS等的应用以及椎间盘源性下腰痛与脑功能结合研究也将带来临床治疗方案的优化。本文重点对T2WI、定量MRI等MRI技术在腰椎退行性改变引起的椎间盘源性下腰痛中的应用现状和发展趋势予以综述,旨在为其早期诊断和椎间盘再生医学疗效评估提供更具潜力的MRI技术支持。

Lower back pain is a prevalent health issue that imposes a significant burden on individuals and society,and discogenic lower back pain caused by disc degeneration is one of the most common etiologic factors.MR techniques are widely used for the routine diagnosis of disc degeneration and its complications.In recent years,with the advancement of artificial intelligence and quantitative techniques,T2WI-based texture analysis as well as various quantitative MR techniques have gradually become important tools for the early diagnosis of discogenic low back pain,the identification of painful discs,and the decision-making of treatment plans,as well as the evaluation of the efficacy of disc regenerative medicine.Multimodal image fusion and artificial intelligence-assisted diagnosis are expected to play an irreplaceable role in the diagnosis and treatment of discogenic low back pain and in the development of new disc therapies,and the application of highly specific disc identification sequences such as CEST and MRS,as well as research on the association between discogenic low back pain and brain function,will also lead to the optimization of clinical treatment plans.In this paper,the current applications and developmental trends of MRI technologies such as T2WI and quantitative MRI in discogenic low back pain caused by lumbar intervertebral disc degenerative are reviewed,with the aim of providing more potential MRI technical support for its early diagnosis and the evaluation of the efficacy of disc regenerative medicine.