基于UTE成像技术评估软骨终板损伤的可行性研究
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国家自然科学基金(81701652)


The assessment of cartilage endplate damage using UTE imaging
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    摘要:

    目的:研究超短回波序列(ultra-short echo time,UTE)评估软骨终板(cartilage endplate,CEP)损伤的可行性。方法:对36例下腰痛患者进行UTE序列及常规腰椎磁共振序列扫描,选取其中85个CEP。将所得到的UTE图像处理成更清晰的UTE CEP图像,并通过计算图像的信噪比(signal to noise ratio,SNR)及对比信噪比(contrast to noise ratio,CNR)来评价图像质量。在UTE CEP图像的基础上,参考Rajasekaran分级并根据CEP及骨性终板的形态将终板分为6级。两位肌骨放射方向医师独立评估终板损伤,评估结果应用Cohen’s kappa分析检验一致性。最后评估85个终板Modic改变的分布情况。结果:UTE CEP图像的SNR及CNR(平均SNR:33.06±2.92;平均CNR:9.4±2.08)高,证明图像具有较高的成像质量。两位肌骨放射医师独立评估6级终板形态的Cohen’s kappa系数为0.816。85个终板中34个存在Modic改变,Cochran-Armitage分析示终板损伤与Modic改变间存在线性趋势(P < 0.000 5)。结论:UTE成像可能会成为临床上评价CEP损伤较为有效的方式。评估Modic改变的分布情况,发现损伤越严重的终板越容易出现Modic改变。

    Abstract:

    Objective:This study aims to investigate the feasibility of ultra-short echo time(UTE) imaging for assessing the cartilage endplate(CEP)damage. Methods:MR imaging of 85 CEPs from 36 patients with low back pain was performed at 3T MR using UTE imaging and routine lumbar MR sequences. UTE image of CEP was postprocessed into subtracted UTE image. Signal to noise ratio(SNR)and contrast to noise ratio(CNR)were calculated to evaluate the subtracted UTE image quality. Based on the subtracted UTE images and Rajasekaran grading,the endplates were classified into six grades according to the damage of CEP and bony endplate. Two musculoskeletal radiologists assessed the grade of endplate damage based on the subtracted UTE images. Agreement between two radiologists was determined using Cohen’s kappa analysis. The distribution of Modic change in 85 endplates were evaluated. Results:The resultant subtracted UTE image quality was confirmed by high SNR and CNR(mean SNR:33.06±2.92;mean CNR:9.4±2.08). Six grades of endplates were evaluated by two radiologists in substantial agreement with Cohen’s kappa of 0.816. Modic changes were found in 34 of 85 endplates. Cochran-Armitage analysis showed linear trend between the degree of endplate damage and Modic change(P < 0.000 5). Conclusion:UTE imaging might be considered as an effective tool to assess the CEP damage in clinic. The distribution of Modic changes shows that the more serious the damage of endplate,the more likely Modic changes appear.

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纪执琳,时 寅,邹月芬.基于UTE成像技术评估软骨终板损伤的可行性研究[J].南京医科大学学报(自然科学版),2022,42(3):370-375

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  • 收稿日期:2021-08-07
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  • 在线发布日期: 2022-03-28
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