冠状位T2-weighted Dixon成像在棘间韧带退变分型中的应用价值
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1.南通市通州区人民医院;2.南京医科大学第一附属医院

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国家自然科学基金项目(面上项目,重点项目,重大项目)


The clinical utility of coronal T2-weighted Dixon imaging in the categorization of degeneration of the interspinous ligament.
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1.Nantong Tongzhou District People'2.'3.s Hospital;4.the first affiliated hospital of Nanjing medical university

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    摘要:

    目的:探讨基于磁共振冠状位T2-weighted Dixon成像在下腰痛人群中对棘间韧带退变分型的应用价值。方法:前瞻性收集2022年1月至2023年8月因下腰痛行腰椎MRI检查的60例患者的影像及临床资料。研究组依据冠状位T2-weighted Dixon序列的脂像和水像把整条棘间韧带分为A型、B型、C型、D型和混合型。混合型包括B-C、D-B、D-B-C、D-C四个亚型。对照组采用矢状位T1WI/T2WI序列把棘间韧带中间部分分为A型、B型、C型和D型。比较两组棘间韧带退变分型的差异。结果:两组分型方法结果的一致性分别为:研究组kappa系数:观察者内部[0.852-0.916]和观察者间[0.747-0.753],对照组kappa系数:观察者内部[0.801-0.823]和观察者间[0.689-0.703]。两组相匹配的122条棘间韧带中各型发生率存在统计学差异,其中研究组C型的发生率为54.1%,明显高于对照组(P<0.05)。新增的混合型在研究组中发生率为46.7%,以B-C型和D-C型多见。结论:基于磁共振冠状位T2-weighted Dixon成像的棘间韧带退变分型方法可靠且可重复,提高了棘间韧带的可识别率和C型的检出率,还可进一步区分混合型和亚型。

    Abstract:

    Objective: To explore the application value of coronal T2-weighted Dixon imaging based on magnetic resonance imaging in the classification of interspinous ligament degeneration in patients with low back pain. Methods: The imaging and clinical data of 60 patients with low back pain who underwent lumbar MRI examination from January 2022 to August 2023 were prospectively collected. According to the fat and water images of coronal T2-weighted Dixon sequence, the study group divided the whole interspinous ligament into type A, type B, type C, type D and mixed type. The mixed type included B-C, D-B, D-B-C and D-C. In the control group, the middle part of the interspinous ligament was divided into type A, type B, type C and type D by sagittal T1WI/T2WI sequence. The difference of degeneration types of interspinous ligament between the two groups was compared. Results: The consistency of the results of the two classification methods was as follows: the kappa coefficient of the study group: intra-observer [0.852-0.916] and inter-observer [0.747-0.753]), and the kappa coefficient of the control group: intra-observer [0.801-0.823] and inter-observer [0.689-0.703]). The incidence of type C in the study group was 54.1%, which was significantly higher than that in the control group (P<0.05). The incidence of new mixed type in the study group was 46.7%, among which B-C and D-C types were the most common. Conclusion: The classification method of interspinous ligament degeneration based on coronal T2-weighted Dixon magnetic resonance imaging is reliable and repeatable, which can improve the identification rate of interspinous ligament and the detection rate of type C, and can further distinguish the mixed type and subtype.

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  • 收稿日期:2023-09-26
  • 最后修改日期:2024-01-04
  • 录用日期:2024-02-27
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