Page 68 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第3期
·370 · Journal of Nanjing Medical University（Natural Sciences） 2022年3月

·临床研究·

基于UTE成像技术评估软骨终板损伤的可行性研究

纪执琳，时 寅，邹月芬 *
南京医科大学第一附属医院放射科，江苏 南京 210029

［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。
［关键词］ 超短回波序列；终板；软骨终板；骨性终板；磁共振成像；Modic改变
［中图分类号］ R445.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）03⁃370⁃06
doi：10.7655/NYDXBNS20220310

The assessment of cartilage endplate damage using UTE imaging

*
JI Zhilin，SHI Yin，ZOU Yuefen
Department of Radiology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［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.
［Key words］ ultra⁃short echo time；endplate；cartilage endplate；bony endplate；magnetic resonance imaging；Modic change
［J Nanjing Med Univ，2022，42（03）：370⁃375］

下腰痛严重影响了人们的生活质量，引起下腰 痛的因素包括椎间盘退变、创伤、代谢性疾病及良
恶性肿瘤等，其中椎间盘退变为主要因素 ，软骨终
［1］
［基金项目］ 国家自然科学基金（81701652） 板（cartilage endplate，CEP）是椎间盘组成中较脆弱
∗ 的结构，其损伤被认为是引起椎间盘退变最重要的原
通信作者（Corresponding author），E⁃mail：zouyuefendc@126.com