【摘要】 目的比较不同场强磁共振成像(magnetic resonance imaging,MRI)设备诊断腰椎间盘退变的价值。方法 120例腰椎间盘退变患者的600个椎间盘,分别采用1.5T和3.0T超导磁共振仪扫描,测得椎间盘表观系数(apparent diffusion coefficient,ADC)值;依据Pfirrmann标准对腰椎间盘进行分级。结果 1.5T MR椎间盘Pfirrmann分级:Ⅰ级31个,Ⅱ级94个,Ⅲ级86个,Ⅳ级78个,Ⅴ级11个;3.0T MR椎间盘Pfirrmann分级:Ⅰ级41个,Ⅱ级80个,Ⅲ级81个,Ⅳ级91个,Ⅴ级7个。不同级别椎间盘ADC值比较,1.5TMR的Ⅳ和Ⅴ级椎间盘ADC值均分别小于Ⅰ、Ⅱ和Ⅲ级,Ⅴ级椎间盘ADC值明显低于Ⅳ级盘(P<0.05)。3.0TMR组Ⅰ和Ⅱ级盘ADC值差异无统计学意义(P>0.05),其余椎间盘随分级增高,ADC值明显减低(P<0.05)。同一级别椎间盘3.0TMR组ADC值明显低于1.5TMR组(P<0.05)。同水平同级别椎间盘2组MR设备ADC值比较,L1/2的各级椎间盘,3.0TMR组ADC值明显小于1.5TMR(P<0.05);L2/3的Ⅱ和Ⅲ~Ⅴ级盘3.0 TMR组ADC值明显小于1.5TMR组(P<0.05);L3/4和L4/5的Ⅲ和Ⅳ~Ⅴ级盘3.0TMR组ADC值明显低于1.5TMR(P<0.05);L5/S1的Ⅰ~Ⅱ级、Ⅲ级和Ⅳ~Ⅴ级盘3.0TMR组ADC值明显低于1.5TMR组(P<0.05)。结论 MR测得的ADC值可用于腰椎间盘退变评估,椎间盘Pfirrmann分级越高,其对应的ADC值越低;与1.5TMR设备比较,3.0TMR对诊断早期轻度腰椎间盘退变更加敏感。更多还原

【Abstract】 Objective To explore the diagnosis value of different magnetic resonance imaging( MRI) equipment for lumbar intervertebral disc degeneration. Methods The 600 discs of 120 cases of lumbar disc degeneration were divided into 2groups,the data were obtained by using 1. 5T( Avanto; Siemens,Erlangen,Germany) and 3. 0 T MRI scanner( Verio; Siemens,Erlangen,Germany),apparent diffusion coefficient( ADC) was obtained by Diffusion Weighted Imaging( DWI),using the Pfirrmann’s grading system in 600 discs. Results 1. In 1. 5T group: grade Ⅰ disc 31,grade Ⅱ disc 94,grade Ⅲ disc 86,grade Ⅳ78,and gradeⅤ11; 3. 0T group: gradeⅠ41,gradeⅡ80,grade Ⅲ 81,grade Ⅳ 91,and grade Ⅴ7. 2. In 1. 5T group,there were significant differences in mean ADC values between grade Ⅳ,Ⅴdiscs and grade Ⅰ,Ⅱ,Ⅲ discs. As compared with grade Ⅳ disc,the gradeⅤ discs had a lower ADC values( P < 0. 05). In 3. 0TMR group,there were significant differences in ADC values of every grade discs except for grade Ⅰand Ⅱdiscs( P < 0. 05). Furthermore,there were significant differences in ADC values of every level discs between the two kinds of MRI,the higher grade disc had lower ADC values( P < 0. 05).3. At L1 /2 level disc,as compared with 1. 5TMR,the ADC values were significantly decreased in every grade in 3. 0TMR( P< 0. 05); at L2 /3 level,as compared with 1. 5TMR,lower ADC values were found in gradeⅡ and Ⅲ ~ Ⅴ discs in 3. 0TMR( P < 0. 05); at L3 /4 and L4 /5 level,as compared with 1. 5TMR,ADC values were significantly decreased in grade Ⅲ和Ⅳ ~Ⅴin 3. 0TMR( P < 0. 05); at L5 /S1 level,as compared with 1. 5TMR,lower ADC values were found in gradeⅡ,Ⅲ,and Ⅳ~ Ⅴdiscs in 3. 0TMR( P < 0. 05). Conclusion ADC values detected by DWI can assess lumbar intervertebral disc degeneration,the higher Pfirrmann classification of intervertebral disc,the lower ADC values. As compared with 1. 5TMR,3. 0TMR is more sensitive in the diagnosis of lumbar intervertebral disc degeneration.更多还原