本文選題：椎旁肌 + 功能磁共振成像　； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]通過(guò)對(duì)正常健康志愿者運(yùn)動(dòng)前后腰部背伸肌群(多裂肌、最長(zhǎng)肌、髂肋肌)功能磁共振(functional magnetic resonance imaging,fMRI)成像研究,包括血氧依賴水平成像(blood oxygen level dependent,BOLD)、T2-mapping 等序列。觀察運(yùn)動(dòng)前后腰部背伸肌群各肌肉R2*值及T2值變化特點(diǎn),探討運(yùn)動(dòng)前后腰部背伸肌群fMRI信號(hào)變化特點(diǎn),為腰背部肌肉的影像學(xué)評(píng)估探索新的評(píng)估方法,也為肌肉運(yùn)動(dòng)訓(xùn)練提供理論依據(jù)和指導(dǎo)。[方法]本研究選取30名健康志愿者,其中男、女各15例,年齡在19～30歲,平均年齡(24.81 ±2.29)歲。采用PHILIPS Achieva 3.0TTx磁共振掃描儀,對(duì)健康志愿者運(yùn)動(dòng)前后分別行BOLD、T2-mapping掃描。并分別于L3、L4上緣層面采集運(yùn)動(dòng)前、后腰部背伸肌群(多裂肌、最長(zhǎng)肌、髂肋肌)R2*值、T2值。運(yùn)動(dòng)方式采用簡(jiǎn)易羅馬凳做上半身屈伸運(yùn)動(dòng),整個(gè)運(yùn)動(dòng)過(guò)程有專人負(fù)責(zé)指導(dǎo),以保證動(dòng)作質(zhì)量和動(dòng)作數(shù)量一致。掃描所得圖像在GE公司ADW4.4圖像工作站上進(jìn)行后處理分析,并在ADW4.4圖像工作站上測(cè)量出運(yùn)動(dòng)前后L3、L4上緣層面各肌肉橫截面積(Cross Section Area,CSA)、T2值、R2*值,并重建出BOLD偽彩圖和T2-mapping偽彩圖。應(yīng)用SPSS22.0統(tǒng)計(jì)學(xué)軟件對(duì)所有數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。[結(jié)果]腰部背伸肌群CSA隨BMI增加而增加,其中男性肌肉總CSA大于女性(P0. 001)。運(yùn)動(dòng)后L3、L4上緣層面各肌肉CSA比運(yùn)動(dòng)前明顯增加(P0. 001),其中L3上緣層面多裂肌運(yùn)動(dòng)前后CSA變化量較其它肌肉小(P0. 05),并且女性組L3上緣層面左右兩側(cè)髂肋肌運(yùn)動(dòng)前后CSA變化量差異顯著(P0. 05),而男性組無(wú)此差異(P0. 05)。運(yùn)動(dòng)后L3、L4上緣層面各肌肉R2*值明顯減低,但L3上緣水平多裂肌運(yùn)動(dòng)前后R2*值比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0. 064)。并且女性組L3上緣層面左右兩側(cè)髂肋肌運(yùn)動(dòng)前后R2*值變化量差異有統(tǒng)計(jì)學(xué)意義(P0. 05),而男性組無(wú)此差異(P0. 05)。運(yùn)動(dòng)后L3、L4上緣層面各肌肉T2值比運(yùn)動(dòng)前顯著增加(P0.001),其中L3上緣層面左右兩側(cè)多裂肌運(yùn)動(dòng)前后T2值變化量比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),其余肌肉左右兩側(cè)對(duì)比,變化量無(wú)統(tǒng)計(jì)學(xué)意義。[結(jié)論]運(yùn)動(dòng)后,L3、L4上緣層面各肌肉運(yùn)動(dòng)前后CSA變化量與R2*值變化量一致,因此可以采用BOLD成像可以從血流灌注角度對(duì)肌肉運(yùn)動(dòng)前后進(jìn)行評(píng)估,并可以根據(jù)局部肌肉血流灌注差異對(duì)運(yùn)動(dòng)過(guò)程中肌肉收縮程度進(jìn)行評(píng)估。T2-mapping成像通過(guò)檢測(cè)肌肉間隙內(nèi)水分子變化可以對(duì)肌肉運(yùn)動(dòng)范圍及程度進(jìn)行評(píng)估。
[Abstract]:[objective] to study the functional magnetic resonance imagingfMRI imaging of the lumbar dorsal extensor muscle before and after exercise in healthy volunteers, including blood oxygen level independent T 2-mapping sequences.The changes of R2 * value and T2 value of each muscle of extensor dorsalis loin group before and after exercise were observed, and the changes of fMRI signal of extensor muscle group in lumbar dorsal muscle group before and after exercise were discussed, and a new evaluation method was explored for the imaging evaluation of lumbar dorsal muscles.Also provides the theoretical basis and the instruction for the muscle movement training.[methods] A total of 30 healthy volunteers, 15 males and 15 females, aged 19 to 30 years, with an average age of 24.81 鹵2.29 years, were selected.PHILIPS Achieva 3.0TTx magnetic resonance scanner was used to scan the healthy volunteers before and after exercise.The posterior loin extensor muscle group (polyfissure muscle, longest muscle, iliac rib muscle) was collected at the upper margin of L3 / L4.The simple Roman bench is used to do the upper body flexion and extension, and the whole movement process is guided by a special person to ensure the quality and quantity of the movement is the same.The scanned images were processed and analyzed on the ADW4.4 image workstation of GE Company, and the cross-sectional area of each muscle on the upper edge of L3L4 before and after exercise was measured on the ADW4.4 image workstation. The T _ 2 value of the cross Section area was measured and the value of R2 * was reconstructed. The pseudochromatic BOLD and T2-mapping pseudo-color images were reconstructed.All the data were analyzed by SPSS22.0 software.[results] the CSA of extensor dorsalis loin group increased with the increase of BMI, and the total CSA of male muscle was greater than that of female group P0.001g.After exercise, the CSA of each muscle on the upper edge of L _ 3 and L _ 4 increased significantly compared with that before exercise.The changes of CSA in L3 upper margin were smaller than those in other muscles before and after exercise.In the female group, there was a significant difference in CSA between the left and right iliac rib muscles before and after exercise on the upper margin of L3, and there was a significant difference between the two groups (P 0. 0).There was no difference between male group and male group (P 0. 0).05.After exercise, the R2 * values of the muscles on the upper edge of L3 and L4 decreased significantly, but there was no significant difference in R2 * values between the two groups before and after exercise.064.In female group, there was significant difference in R2 * between the left and right iliac rib muscles on the upper margin of L3 before and after exercise (P 0. 0).There was no difference between male group and male group (P 0. 0).05.After exercise, the T _ 2 value of each muscle on the upper edge of L _ 3 / L _ 4 was significantly higher than that before and after exercise (P _ (0.001)). There was a significant difference in the changes of T _ 2 value between the left and right sides of the polyfissure muscle on the upper edge of L _ 3, but there was no significant difference in the changes between the left and right sides of the other muscles.[conclusion] the changes of CSA before and after exercise are consistent with that of R2 * on the upper edge of L3 / L4 after exercise. Therefore, BOLD imaging can be used to evaluate the muscle before and after exercise from the angle of blood perfusion.The range and degree of muscle movement can be evaluated by measuring the changes of water molecules in the muscle gap by using the T2-mapping imaging to evaluate the muscle contractility according to the difference of regional muscle perfusion.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2;R685

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