磁共振T2WI压脂序列在Modic改变分型中应用价值研究
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江苏高校优势学科建设工程资助项目(JX10231801)


Application value of magnetic resonance fat-suppressed T2WI sequence in classification of Modic changes
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    目的:评价在1.5T的MR系统成像仪中T2WI压脂序列在Modic改变分型中的应用价值-方法:回顾性分析2013年11月~2014年3月间因腰腿痛行腰椎MRI检查的276例患者的MRI资料,进行Modic分型的对比研究-通过双盲法采用两种方法进行分型-分别是方法1:T1WI-T2WI序列;方法2:T1WI-T2WI-T2WI-FS序列-2位医师分别采用方法1-2将Modic改变分型-结果:两位医师分型结果一致率分别为方法1:98.66%,Kappa=0.925(P < 0.001);方法2:99.49%,Kappa=0.975(P < 0.001)-采用方法1-2将终板退变分为ModicⅠ型-Ⅱ型-Ⅲ型-混合型,且两种方法检出个数差异有统计学意义(P < 0.001)-同时对混合型进一步分析亚型,分7个亚型,分别为Ⅰ/Ⅱ-Ⅱ/Ⅰ-Ⅲ/Ⅱ-Ⅱ/Ⅲ-Ⅰ/Ⅲ-Ⅲ/Ⅰ-Ⅰ/Ⅱ/Ⅲ型,其中Ⅰ/Ⅱ型和Ⅱ/Ⅰ型最多-结论:磁共振T2WI压脂序列联合T1WI-T2WI序列能在影像学上提高对ModicⅠ型-混合型的检出率,对Modic改变分型优于传统的T1WI和T2WI序列,还可依改变区域MR信号对混合型进一步分类-

    Abstract:

    Objective:To evaluate the application value of fat-suppressed T2WI sequence in Modic changes at a 1.5T magnetic Resonance (MR) system. Methods:Total 276 cases from November 2013 to March 2014 with lumbocrural pain had been performed MR scan with T1WI,T2WI and T2WI-FS. A retrospective analysis of Modic classification was applied on these data. Two musculoskeletal radiologists used two methods to classify Modic changes with the double-blind method:one according to T1WI and T2WI,and the another according to T1WI,T2WI and T2WI-FS. Results:Doctor A and B observed the Modic changes using method 1 and 2,respectively. The coincidence rate between two observers were 98.66%,Kappa=0.925 (method 1,P < 0.001);99.49% and Kappa=0.975(method 2,P < 0.001). Modic changes were divided into type Ⅰ,Ⅱ,Ⅲ and mixed. There were statistically significant differences between the two methods about the detection rate. Meanwhile,mixed type was further divided into 7 subtypes,namely typeⅠ/Ⅱ,typeⅡ/Ⅰ,type Ⅲ/Ⅱ,type Ⅱ/Ⅲ,typeⅠ/Ⅲ,type Ⅲ/Ⅰand typeⅠ/Ⅱ/Ⅲ. Among them,typeⅠ/Ⅱ and type Ⅱ/Ⅰconstituted the majority. Conclusion:Fat-suppressed T2WI sequence combined with T1WI and T2WI could increase the positive detection rate of Modic I type and Modic mixed type. It is superior to traditional T1WI and T2WI sequence in the classification of Modic changes. The mixed type can also be further classified into different subtypes according to the signs of MRI.

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许 凤,邹月芬,徐 磊,冯 阳.磁共振T2WI压脂序列在Modic改变分型中应用价值研究[J].南京医科大学学报(自然科学版),2014,(11):1609-1613

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  • 收稿日期:2014-07-14
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  • 在线发布日期: 2014-11-21
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