Page 103 - 南京医科大学学报自然科学版

第44卷第3期 南京医科大学学报（自然科学版）
2024年3月 Journal of Nanjing Medical University（Natural Sciences） ·393 ·

·影像医学研究·

冠状位T2⁃weighted Dixon成像在棘间韧带退变分型中的应用价值

陈 磊 ，邹月芬 ，祁 良 1
1*
1，2
南京医科大学第一附属医院放射科，江苏 南京 210029；南通市通州区人民医院放射科，江苏 南通 226300
1 2

［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—2023年8月因下腰痛行腰椎磁共振成像（magnetic resonance imaging，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 4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析显示，研究组 Kappa 系数：观察者内部为 0.852~
0.916，观察者间为0.747~0.753；对照组Kappa系数：观察者内部为0.801~0.823，观察者间为0.689~0.703。两组相匹配的122条
棘间韧带分型结果存在统计学差异（P < 0.05），其中研究组C型的发生率为54.1%，明显高于对照组9.0%。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及其亚型。
［关键词］ 下腰痛；棘间韧带；磁共振成像；水脂分离技术
［中图分类号］ R445.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）03⁃393⁃05
doi：10.7655/NYDXBNSN230901

The application value of coronal T2 ⁃ weighted Dixon imaging in interspinous ligament

degeneration classification
1，2
1*
CHEN Lei ，ZOU Yuefen ，QI Liang 1
2
1 Department of Radiology，the First Affiliated Hospital of Nanjing Medical Uinversity，Nanjing 210029；Department
of Radiology，Tongzhou District People’s Hospital，Nantong 226300，China

［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：Imaging and clinical data of 60
patients with low back pain who underwent lumbar magnetic resonance imaging（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 research group
classified the entire interspinous ligament into type A，B，C，D and mixed type. The mixed type included four subtypes：B⁃C，D⁃B，D⁃B⁃
C，and D⁃C. In the control group，the middle part of the interspinous ligament was classified into type A，B，C，and D by sagittal T1WI/
T2WI sequence. Differences of degeneration types of interspinous ligament between the two groups were compared. Results：The
consistency of results between the two classification methods was as follows：for the research group，the Kappa coefficient within
observers ranged from 0.852 to 0.916，and between observers ranged from 0.747 to 0.753；for the control group，the Kappa coefficient
within observers ranged from 0.801 to 0.823，and between observers ranged from 0.689 to 0.703. The classification results of 122
interspinous ligaments were statistically different between the two groups（P < 0.05）. The incidence of type C in the research group was
54.1%，significantly higher than 9% in the control group. The newly added mixed type had an incidence of 46.7% in the research
group，with B⁃C type and D⁃C type being more common. Conclusion：The classification method of interspinous ligament degeneration
based on coronal T2⁃weighted Dixon magnetic resonance imaging is reliable and reproducible，which can improve the identification
rate of interspinous ligament and the detection rate of type C，and can further distinguish the mixed types and its subtypes.
［Key words］ low back pain；interspinous ligament；magnetic resonance imaging；dixon
［J Nanjing Med Univ，2024，44（03）：393⁃397］
［基金项目］ 国家自然科学基金（81701652）
∗
通信作者（Corresponding author），E⁃mail：zou⁃yf@163.com