【摘要】 目的通过对比常用的椎间盘分级方法,探讨通过MRI矢状位T2 mapping对腰间盘进行分级的可行性。方法随机选取50位健康志愿者,MRI矢状位扫描L3/4、L4/5、L5/S1共150个椎间盘。采用常规FSE序列和多回波SE序列扫描,然后图像后处理进行T₂ mapping成像。应用T₂ mapping分级法和两种常用的椎间盘分级方法对各椎间盘进行分级。通过Kappa检验验证T₂图分级法在应用中的符合率和一致性,并比较分级法之间的联系和区别。测量椎间盘髓核T2值,比较各分级法中T2值与椎间盘级别之间的关系。结果三种分级方法的符合率和一致性均为显著（k≥0.60）。常用分级方法归类为Ⅰ级的椎间盘比通过T₂ mapping分级法归类为Ⅰ级的椎间盘多,而归类为Ⅱ、Ⅲ级的椎间盘比T₂ mapping分级法要少。T₂ mapping方法中各级别髓核T2均值间有显著性差异（p<0.05）。而传统及Pfirrmann’s分级方法中,Ⅱ级和Ⅲ级以及Ⅲ级和Ⅳ级椎间盘髓核T2均值间没有显著性差异。结论通过MRI矢状位T2 mapping对腰间盘进行分级,可以对椎间盘髓核T2值进行测量,并有助于发现椎间盘早期退行性改变,比常用的椎间盘分级方法更具优势。更多还原

【Abstract】 Objective To investigate the feasibility of MRI sagittal T2 mapping lumbar intervertebral disc grading by comparing the commonly used grading methods. Methods A total of 50 healthy volunteers were randomly selected. MRI sagittal scans were performed on L3/4 L4/5,and L5/S1,with a total of 150 intervertebral discs. A conventional FSE sequence and a multi-echo SE sequence were used in scanning,followed by T2 mapping image post-processing.Each disc was graded using the T2 mapping method and two commonly used disc grading methods.The Kappa test is used to verify the conformity and consistency of the T2 graph grading method in the application,and to compare the links and differences between the grading methods.The T2 value of the nucleus pulposus of the intervertebral disc was measured,and the relationship between the T2 value and the intervertebral disc grading level in each classification method was compared.Results The coincidence rate and consistency of the three grading methods were significant( k≥0. 60).The discs graded as Class Ⅰ by the commonly used classification method are more than those graded as Class I by T2 mapping,and the discs classified as Grade Ⅱ and Ⅲ are less than the T2 mapping method.There was a significant difference( P<0. 05) between the T2 mean values of the nucleus pulposus in each level in the T2 mapping method. In the traditional and Pfirrmann’s grading methods,there was no significant difference in the T2 mean value between the grade Ⅱ and Ⅲ and the grade Ⅲ and Ⅳ of nucleus pulposus.Conclusion The grading of the lumbar intervertebral disc by MRI sagittal T2 mapping can measure the T2 value of the intervertebral disc nucleus and help to find early degenerative changes of the intervertebral disc,which is more advantageous than the commonly used intervertebral disc grading method.更多还原