本文選題：磁共振成像　切入點(diǎn)：頸椎　出處：《南方醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：第一章頸椎間盤退變與Miyazaki分級研究目的通過分析頸椎間盤節(jié)段、受檢者性別和年齡與Miyazaki分級的關(guān)系,探討頸椎間盤退變相關(guān)的生理因素,為之后定量分析奠定基礎(chǔ)。材料和方法收集2016年6月～10月來我院行頸椎MRI檢查患者82例。使用GE Signa HDXT1.5T超導(dǎo)MRI、CTL脊柱相控陣線圈進(jìn)行頸椎掃描,FSE序列采集常規(guī)矢狀位T2WI圖像,并依據(jù)頸椎間盤Miyazaki分級標(biāo)準(zhǔn)進(jìn)行分級。應(yīng)用SPSS 22.0軟件,對頸椎間盤Miyazaki分級與頸椎間盤節(jié)段、受檢者性別及年齡分別進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果共納入410個(gè)頸椎間盤節(jié)段進(jìn)行研究,Miyazaki Ⅰ級椎間盤18個(gè)、Ⅱ級94個(gè)、Ⅲ級204個(gè)、Ⅳ級83個(gè)、V級11個(gè)。不同頸椎間盤節(jié)段Miyazaki等級有顯著性差異(P=0.003)。不同性別頸椎間盤Miyazaki等級未見顯著性差異(P=0.172)。除Ⅳ和Ⅴ級外,不同頸椎間盤Miyazaki等級受檢者年齡有顯著性差異,且年齡與頸椎間盤Miyazaki等級呈正相關(guān)(rs=0.554,P=0.000)。結(jié)論Miyazaki分級系統(tǒng)作為一種專用于評價(jià)頸椎間盤退變的影像學(xué)分級系統(tǒng),對頸椎間盤退變的評估具有一定價(jià)值。但該分級系統(tǒng)是基于信號強(qiáng)度為主的主觀視覺評估系統(tǒng),且不能盡早的發(fā)現(xiàn)并量化椎間盤的退變。第二章頸椎間盤退變的T2 Mapping成像研究目的應(yīng)用GE 1.5T磁共振T2 mapping定量成像檢查技術(shù)對參照Miyazaki標(biāo)準(zhǔn)進(jìn)行分級的頸椎間盤的髓核進(jìn)行測量、比較,以此評價(jià)T2 mapping定量成像檢查技術(shù)對頸椎間盤退變的診斷價(jià)值,為影像學(xué)診斷頸椎間盤退變及準(zhǔn)確量化分級提供依據(jù),為臨床確診頸椎間盤退變提供參考。材料和方法收集2016年6月～10月臨床確診或懷疑頸椎病而來我院行頸椎MRI檢查患者共81例。檢查時(shí)間均為早上7:30-9:00。使用GE Signa HDXT 1.5T超導(dǎo)MRI、CTL脊柱相控陣線圈進(jìn)行頸椎掃描。掃描序列有軸位T2WI,矢狀位T1WI、T2WI、T2壓脂以及T2 mapping。以T2WI正中矢狀位圖像為基礎(chǔ)依據(jù)Miyazaki分級系統(tǒng)進(jìn)行椎間盤分級。將T2 mapping序列掃描所得原始數(shù)據(jù)傳入GE AW 4.6后處理工作站,打開Functool/T2 mapping軟件,設(shè)置偽彩圖上彩色標(biāo)尺的T2值范圍,經(jīng)過軟件對數(shù)據(jù)的重建和分析得到T2弛豫時(shí)間偽彩圖。最后選取T2弛豫時(shí)間偽彩圖正中矢狀面對應(yīng)的T2 mapping原始數(shù)據(jù)圖層面作為感興趣層面,結(jié)合偽彩圖的顯示在C2～C7各椎間盤髓核區(qū)自前向后分5等份為5個(gè)感興趣區(qū)域(regions of interest,ROls),面積均約5mm2。分別測量各感興趣區(qū)T2值3次,最后取平均值。髓核T2值來源于5個(gè)感興趣區(qū)域T2值的平均值。采用SPSS 22.0軟件,對不同的Miyazaki等級、相同Miyazaki等級不同區(qū)域,不同椎間盤節(jié)段、相同節(jié)段不同區(qū)域,受檢者性別及年齡組(≤35,35～50,50)分別與椎間盤髓核的T2弛豫時(shí)間值進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果81位受檢者共405個(gè)頸椎間盤,Miyazaki分級Ⅰ級椎間盤15個(gè),Ⅱ級91個(gè),Ⅲ級216個(gè),Ⅳ級75個(gè),V級8個(gè)。除去Ⅴ級椎間盤,本研究納入頸椎間盤共397個(gè);不同Miyazaki分級的頸椎間盤髓核T2值差異有統(tǒng)計(jì)學(xué)意義(F=10.150,P=0.000)。Dnnett T3法兩兩比較,各級間差異也有統(tǒng)計(jì)學(xué)意義(P=0.000)。且頸椎間盤髓核T2值與Miyazaki分級呈顯著負(fù)相關(guān)(rs=-0.833,P=0.000);頸椎間盤相同Miyazaki等級不同感興趣區(qū)域的T2值差異有統(tǒng)計(jì)學(xué)意義(P=0.000);不同節(jié)段的頸椎間盤髓核T2值差異有統(tǒng)計(jì)學(xué)意義(P=0.000)。且頸椎間盤髓核T2值與節(jié)段呈弱正相關(guān)(rs=0.363,P=0.000);頸椎間盤相同節(jié)段不同感興趣區(qū)域的T2值差異有統(tǒng)計(jì)學(xué)意義(P=0.000);在頸椎間盤各節(jié)段,性別與髓核T2值差異均無統(tǒng)計(jì)學(xué)意義;年齡組與頸椎間盤髓核的T2值差異有統(tǒng)計(jì)學(xué)意義(F=10.890,P=0.000)。Dnnett T3法兩兩比較,各組間差異也有統(tǒng)計(jì)學(xué)意義(P=0.000)。且年齡與頸椎間盤髓核的T2值呈中度負(fù)相關(guān)(rs=-0.550,P=0.000)。結(jié)論T2 mapping成像可以作為一種定量分析的手段,用以評估頸椎間盤的退變,使客觀、無創(chuàng)性的量化評價(jià)活體椎間盤的生理狀態(tài)及退變程度成為可能,為早期診斷和早期預(yù)防治療頸椎間盤退變提供依據(jù)。
[Abstract]:The first chapter study on the classification of cervical intervertebral disc degeneration and Miyazaki objective through the analysis of cervical intervertebral disc segments, the relationship between gender and age and Miyazaki grade subjects of cervical disc degeneration associated physiological factors, to lay the foundation of quantitative analysis. Materials and methods from June 2016 to October in our hospital 82 patients with cervical MRI examination the use of GE Signa HDXT1.5T. MRI CTL superconducting, phased array coil for cervical spine FSE scan sequence acquisition routine sagittal T2WI images, and on the basis of the Miyazaki standard classification of cervical intervertebral disc were graded. The application of SPSS 22 software, Miyazaki grading of intervertebral disc and cervical intervertebral disc segments, subjects of sex and age were analyzed statistically. Results a total of 410 cervical intervertebral disc segments of Miyazaki grade disc 18, grade 94, grade 204, grade 83, V grade 11. Different cervical intervertebral disc segments Miy The azaki level had significant difference (P=0.003). No significant difference Miyazaki grade gender cervical (P=0.172). In addition to IV and V grade, different grades of cervical intervertebral disc Miyazaki subjects age has significant differences, and the age and cervical intervertebral disc Miyazaki level was positively correlated (rs=0.554, P=0.000) conclusion. The Miyazaki grading system as a dedicated to the evaluation of cervical disc degeneration imaging classification system, and has a certain value in evaluation of cervical disc degeneration. But the grading system is mainly based on the signal intensity of the subjective visual evaluation system, and not as soon as possible and to quantify the degeneration of intervertebral disc. The second chapter cervical intervertebral disc degeneration the T2 Mapping imaging objective GE 1.5T magnetic resonance imaging technology T2 mapping quantitative classification of cervical intervertebral disc nucleus pulposus of referring to Miyazaki standard measurement, comparison, in order to evaluate T2 mapping The value of quantitative imaging technique in the diagnosis of cervical intervertebral disc degeneration, diagnosis of cervical disc degeneration and accurate quantitative classification to provide the basis for imaging, provides the reference for the clinical diagnosis of cervical intervertebral disc degeneration. Materials and methods from June 2016 to October diagnosed or suspected of cervical spondylosis and cervical MRI examination in our hospital patients in 81 cases. Check the time for the use of GE Signa HDXT 1.5T at 7:30-9:00. MRI CTL superconducting, phased array coil for cervical spine CT scan. The sequence of axial T2WI, sagittal T1WI, T2WI, T2 and T2 mapping. with T2WI fat midsagittal images based on Miyazaki classification system for disc T2 classification. Mapping sequences derived from the original data into GE AW 4.6 postprocessing workstation, open the Functool/T2 mapping software, set the pseudo color color scale range of the T2 value, after the data and reconstruction software Analysis of T2 relaxation time of the pseudo color map. Finally select the T2 relaxation time of pseudo color image median sagittal face should be T2 mapping original data map level as the interest level, combined with the pseudo color display in C2 ~ C7 of the intervertebral disc nucleus area from front to back is divided into 5 equal parts into 5 regions of interest (regions of interest, ROls, 5mm2.) were measured in each area were about 3 times the value of T2 in the region, and finally averaged. The average T2 value of NP from 5 regions of interest T2 value. Using SPSS 22 software for different Miyazaki levels, different areas of the same grade of Miyazaki, with the disc section section of the same segment in different regions, the subjects of sex and age group (35,35 ~ 50,50) were statistically analyzed respectively with intervertebral disc nucleus T2 relaxation time values. Results 81 subjects were 405 cervical intervertebral disc Miyazaki, disc 15 grade I, grade II in 91. Grade 216, class IV 75, V grade 8. Remove the V-grade disc, this study included a total of 397 cervical intervertebral disc; cervical Miyazaki stages of nucleus pulposus T2 value were statistically significant (F=10.150, P=0.000).Dnnett T3 22, there were significant differences between all levels (P=0.000) and cervical. Disc nucleus T2 value was negatively correlated with the Miyazaki grade (rs=-0.833, P=0.000); the different grade of cervical intervertebral disc the same Miyazaki region of interest T2 value difference was statistically significant (P=0.000); cervical segment of the nucleus pulposus of T2 value were statistically significant (P=. 0) and cervical intervertebral disc nuclear T2 values showed a weak positive correlation with segments (rs=0.363, P=0.000); cervical intervertebral disc of the same segment in different regions of interest T2 value difference was statistically significant (P=0.000); in the cervical intervertebral disc segments, gender and nucleus T2 values showed no statistically significant differences in age group; and cervical intervertebral disc T2 core values The difference was statistically significant (F=10.890, P=0.000).Dnnett T3 22, and the difference between groups was statistically significant (P=0.000). And the age and cervical intervertebral disc nucleus T2 showed a moderate negative correlation (rs=-0.550, P=0.000). Conclusion T2 mapping imaging can be used as a quantitative analysis method, to evaluate the cervical vertebra intervertebral disc degeneration, to make an objective, noninvasive quantitative evaluation in vivo intervertebral disc degeneration and physiological state as possible, for the early diagnosis and early prevention and treatment of cervical intervertebral disc degeneration and to provide the basis.

【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R681.5;R445.2

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