【摘要】 目的:探讨双能CT有效原子序数图在定量研究青年人腰椎间盘退变中的诊断及评估价值。方法:搜集接受双能CT腰椎检查的18～35岁年龄段患者120例（600个椎间盘）并记录下腰痛评分量表（JOA）及患者一般资料。两名放射科医师分别根据2014年北美脊柱外科学会（NASS）定义的腰椎间盘形态分为椎间盘正常、椎间盘膨出及椎间盘突出3组，运用双能CT后处理工作站中的有效原子序数图（Z）测量并记录椎间盘高度、70kVCT值(CT_70kV)、Sn150kVCT值(CT_sn150kV)、混合CT值（rCT）、Rho值（electron density）及Z值；进行单因素方差分析及两两比较，分析JOA评分与椎间盘参数的相关性，并对疼痛等级与患者资料进行单因素方差分析。结果:发现120例患者中以腰4/5、腰5/骶1椎间盘膨、突出为主；依据椎间盘形态分组对椎间盘高度、椎间盘髓核区CT_70kV、CT_sn150kV、rCT、Rho值、Z值进行单因素方差分析，发现腰4/5椎间盘高度、CT_70kV、CT_sn150kV、rCT、Rho值具有统计学差异（P<0.05）;腰5/骶1椎间盘高度、CT_sn150kV、rCT、Rho值、Z值具有统计学差异（P<0.05）,组间比较提示，椎间盘突出组在高度、CT_sn150kV、rCT、Rho值方面与正常组和膨出组有显著差异（P<0.05）。JOA疼痛评分与椎间盘高度总数、均数、腰2/3椎间盘高度及腰5/骶1椎间盘Rho值具有统计学差异（P<0.05）;且疼痛等级与睡眠质量相关（P<0.05）。结论:双能CT有效原子序数图可以定量评判青年人腰椎间盘退变的严重程度。更多还原

【Abstract】 Objective:To explore the diagnostic and evaluation value of dual-energy CT effective atomic number map in the quantitative study of lumbar disc degeneration in young people.Methods:120 patients（600 intervertebral discs） aged 18～35 years who underwent dual-energy CT lumbar spine examination were collected.Japanese Orthopaedic Associationscores（JOA） were recorded.According to the 2014 North American Spine Society（NASS） definition of lumbar disc morphology, the discs were divided into three groups: normal disc, bulging disc and herniated disc by two radiologists.Intervertebral disc height, 70kVCT value(CT_70kV),Sn150kVCT value(CT_sn150kV),regular CT value（mixed CT value）,Rho（electron density） and Z value were measured and recorded using the effective atomic number（Z） map in the dual-energy CT post-processing workstation.The correlation between JOA score and intervertebral disc parameters was analyzed by one-way ANOVA and pound-for-pair comparison, and the pain grade and patient data were analyzed by one-way ANOVA.Results:According to the observation of intervertebral disc morphology, the bulging and protrusion of intervertebral disc in lumbar 4/5 and lumbar 5/sacral 1 were the main cases in 120 patients.In the three groups, univariate ANOVA was performed for disc height、CT_70kV,CT_sn150kV,rCT,Rho value and Z value, and it was found that lumbar 4/5 disc height, CT_70kV,CT_sn150kV,rCT and Rho value had statistical differences（P<0.05）.The lumbar disc height, CT_sn150kV,rCT,Rho value and Z value of lumbar 5/sacral 1 had statistical differences（P<0.05）.The results showed that there were significant differences in the height, CT_sn150kV,rCT and Rho values between the disc herniation group and the normal group and the bulging group（P<0.05）.There were significant correlations between JOA pain score and the total disc height, mean disc height, lumbar 2/3 disc height, lumbar 5/sacral 1 disc Rho（P<0.05）,while pain rating was significantly correlated with sleep quality（P<0.05）.Conclusion:Dual-energy CT effective atomic number map can quantitatively evaluate the severity of lumbar disc degeneration in young people.更多还原