本文關(guān)鍵詞： 測量 腰椎 磁共振 橫切 面上 椎間盤 髓核 信號 評估 變的 可行性研究　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討在橫切面磁共振圖像測量腰椎間盤及髓核信號用以評估椎間盤退變的可行性。方法:收集一般人群腰椎磁共振掃描圖像。在T2加權(quán)像上利用影像分析軟件Spine Explorer手工選取正中矢狀位椎間盤和橫切面椎間盤及髓核的區(qū)域,其中橫切面上髓核面積為椎間盤的58%,測量橫切面圖像L1-S1椎間盤、髓核平均信號和信號標(biāo)準(zhǔn)差及鄰近后方腦脊液平均信號;測量矢狀位圖像椎間盤平均信號和信號標(biāo)準(zhǔn)差及鄰近后方腦脊液平均信號。信號測量均以臨近腦脊液平均信號予以校正。計算信號測量值與年齡相關(guān)性(相關(guān)系數(shù),r),對比橫切面椎間盤、髓核信號及矢狀位椎間盤信號與年齡的相關(guān)系數(shù),評估腰椎間盤退變各種測量方法的有效性。間隔一個月選取其中20例,再次測量各信號值,計算各測量方法的可信度(ICC)。P0.05定義為統(tǒng)計學(xué)有意義。結(jié)果:研究納入66例一般人群樣本,男33例,女33例,平均年齡50.3±16.5歲(24-82歲),共分析測量330個腰椎間盤T2加權(quán)像上的信號。矢狀位上椎間盤平均信號測量和信號標(biāo)準(zhǔn)差只有中度的測量可信度(ICC=0.63和0.73),橫切面上椎間盤及髓核的信號測量表現(xiàn)為極強(qiáng)的可信度(ICC0.80)。T2W像正中矢狀位椎間盤平均信號和信號標(biāo)準(zhǔn)差與年齡有較好的相關(guān)性(r分別為-0.50和-0.67,P0.001);橫切面上,椎間盤信號標(biāo)準(zhǔn)差與年齡中度負(fù)相關(guān)(r=-0.41,P0.01),而平均信號與年齡沒有相關(guān)性(P=0.319);橫切面髓核平均信號與年齡表現(xiàn)出中度負(fù)相關(guān)(r=-0.41,P0.01),而信號標(biāo)準(zhǔn)差與年齡無顯著性統(tǒng)計相關(guān)性(P=0.058)。當(dāng)將腰椎分為上腰椎(L1-L4)和下腰椎(L4-S1)分析對比信號與年齡相關(guān)性時,我們發(fā)現(xiàn)上腰椎表現(xiàn)出與上述一致的結(jié)果,而在下腰椎中,橫切面上除了髓核平均信號與年齡表現(xiàn)出較弱的相關(guān)性(r=-0.30,P0.05)外,余橫切面信號量化指標(biāo)與年齡無統(tǒng)計學(xué)意義上的相關(guān)性,而矢狀位椎間盤平均信號和信號標(biāo)準(zhǔn)差與年齡之間仍有著較好的相關(guān)性(r分別為-0.50和-0.59,P0.001)。結(jié)論:在腰椎矢狀位MR圖像上測量椎間盤信號比橫切面圖像上測量椎間盤及髓核信號更能反映椎間盤退變程度。在上腰椎(L1-L4)中,橫切面椎間盤的信號標(biāo)準(zhǔn)差和髓核的平均信號也能一定程度上反映腰椎退變程度;而在下腰椎(L4-S1)中,橫切面各個信號量化指標(biāo)與年齡并沒有明顯的相關(guān)性。
[Abstract]:Objective: to evaluate the feasibility of measuring lumbar disc and nucleus pulposus signals on transverse magnetic resonance imaging. Methods: MRI images of lumbar vertebrae in general population were collected and analyzed on T2 weighted images. The software Spine Explorer manually selected the area of the median sagittal disc and transverse disc and nucleus pulposus. The area of the upper nucleus pulposus on the transverse plane was 58% of that of the intervertebral disc. The L1-S1 intervertebral disc, the mean signal and signal standard deviation of the nucleus pulposus and the average signal of cerebrospinal fluid adjacent to the posterior were measured. The average signal and signal standard deviation of sagittal image disc and the average signal of cerebrospinal fluid near the back of the disc were measured. The signal measurements were corrected by the average signal of adjacent cerebrospinal fluid. The correlation between signal measurement value and age was calculated. Compare the transverse intervertebral disc, The correlation coefficient of nucleus pulposus signal and sagittal disc signal with age was evaluated to evaluate the effectiveness of various measurement methods for lumbar disc degeneration. Results: 66 general population samples, 33 males and 33 females, were included in the study. The mean age was 50.3 鹵16.5 years old and 24-82 years old. A total of 330 signals on T2 weighted images of lumbar intervertebral disc were analyzed and measured. The mean signal measurement and signal standard deviation of sagittal intervertebral disc were only moderately reliable. The nuclear signal measurements showed that the mean signal and signal standard deviation of median sagittal intervertebral disc were significantly correlated with the age of ICC 0.80 and T _ 2W images, and the r values were -0.50 and -0.67g / P 0.001g, respectively, on the transverse plane, the mean signal and the signal standard deviation of the intervertebral disc in the median sagittal position were -0.50 and -0.67g P 0.001, respectively. The standard deviation of intervertebral disc signal was moderately negatively correlated with age, while the mean signal had no correlation with age (P < 0. 319), while the mean signal of nucleus pulposus showed moderate negative correlation with age, but there was no significant statistical correlation between signal standard deviation and age. When the lumbar vertebrae were divided into L1-L4 (L1-L4) and L4-S1 (L4-S1), the correlation between the signal intensity and age was analyzed. We found that the upper lumbar vertebrae showed the same results as above, and in the lower lumbar vertebrae, except for the lower lumbar vertebrae, the mean signal intensity of the nucleus pulposus showed a weaker correlation with age (P 0.05). There was no statistical correlation between the quantization index of the cross section signal and the age. But sagittal intervertebral disc mean signal and signal standard deviation still have good correlation with age, r is -0.50 and -0.59g P0.001 respectively. Conclusion: measuring intervertebral disc signal on sagittal Mr image is better than measuring intervertebral disc on transverse section image. And nucleus pulposus signal can better reflect the degree of disc degeneration. In L1-L4 of the upper lumbar vertebrae, The signal standard deviation of transverse intervertebral disc and the average signal of nucleus pulposus can also reflect the degree of lumbar degeneration to some extent, but in L4-S1 of lower lumbar vertebra, there is no obvious correlation between the quantification index of signal and age.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R681.53;R445.2

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