摘要
目的采用CT技术定量测量椎旁肌肉的密度,评价椎旁肌肉CT值与腰椎小关节退行性变的相关性。方法搜集临床下腰痛患者101例,男44例,女57例,行常规腰椎CT横断面扫描,利用Pathria分级标准对腰椎小关节进行分级,由两名经验丰富的影像学医师测量L3~S1节段椎小关节中心层面腰大肌(PS)、多裂肌(MF)、竖脊肌(ES)的CT值;椎旁肌CT值根据同层面椎小关节Pathria分级相应的分为四组;用ANOVA单因素方差分析比较不同腰椎小关节Pathria分级组间相应层面椎旁肌CT值差异;用Pearson相关性分析评价腰椎小关节Pathria退行性变程度与椎旁肌肉CT值的相关性。P<0.05为差异有统计学意义。结果PS、MF及ES的CT值在不同腰椎小关节Pathria分级间差异均有统计学意义。椎小关节Pathria分级与年龄、体质指数(BMI)均存在相关性[相关系数(r)分别为0.35,0.17,均P=0.00];控制年龄、BMI因素后,椎小关节Pathria分级与PS、ES和MF的CT值均存在相关性(r分别为-0.19,-0.53,-0.45,均P=0.00)。左、右两侧椎旁肌与椎小关节退变分级的相关性无明显差别;不同节段椎旁肌与腰椎小关节Pathria分级相关性与整体一致,相关性为MF>ES>PS;性别因素对PS影响最明显,对MF、ES影响差异不大。结论ES和MF的CT值与腰椎小关节退变程度存在中等程度负相关,PS的CT值与腰椎小关节退变程度存在弱的负相关。
Objective To investigate the relationship between paravertebral muscle density and intervertebral disc degeneration with quantitative CT technique.Methods 101 patients(44 male,57 female)with low back pain or sciatica were enrolled in this study.The lumbar imaging protocol was routine axial CT.Degeneration of facet jointin in L3-S1 segment were qualitatively evaluated by using Pathria grading system in axial scanning CT imaging.Two experienced radiologists were employed to measure the CT values of the central plane of the L3-S1 vertebral facet joint relative to psoas muscle(PS),multifidus muscle(MF),and erector spinae muscle(ES).The paravertebral muscles were classifed according to 4 Pathria grades of the same level of DOFJ into 4 groups.Univariate analysis of variance(ANOVA)was employed to judge the difference of the density of paravertebral muscles among these groups.Pearson correlation analysis was used to evaluate the correlation between Pathria degeneration of DOFJ and degeneration of paravertebral muscles,and P<0.05 was considered statistically signifcant.Results Pathria grades of DOFJ were associated with the Age,and BMI(correlation coeffcients were 0.35,0.17,P values were 0.00);After control age and BMI,Pathria grades of DOFJ were associated with the CT value of PS,ES and MF(correlation coeffcients were-0.19,-0.53,-0.45,P values were0.00).There were no significant differences in the correlation between the right and left paravertebral muscles and the grade of facet joint degeneration.The grading correlation between paraspinal muscle and lumbar facet joint Pathria at different segments was consistent with the whole,and the correlation was all MF>ES>PS.Gender factors had the most obvious effect on PS,but had little effect on MF and ES.Conclusion There was a moderate correlation between the CT value of ES and MF and the grade of facet joint degeneration,while that of PS was weak.
作者
敖莹盈
郭亮
邓小丽
陈思浩
黄觅
王叶
李晓兰
AO Yingying;GUO Liang;DENG Xiaoli(Department of Medical Imaging,The University-Town Hospital of Chongqing Medical University,Chongqing 401331,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第12期2498-2502,共5页
Journal of Clinical Radiology
关键词
腰椎小关节
椎旁肌肉
退行性变
CT值
Facet joint
Paravertebral muscle
DegenerationCT
Hounsfield unit value
作者简介
通讯作者:李晓兰
