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定量磁共振T2映射成像在椎间盘退变中的研究进展

薛丛洋 王楠 徐文强 席志鹏 谢林

薛丛洋, 王楠, 徐文强, 席志鹏, 谢林. 定量磁共振T2映射成像在椎间盘退变中的研究进展[J]. 分子影像学杂志, 2022, 45(3): 447-453. doi: 10.12122/j.issn.1674-4500.2022.03.28
引用本文: 薛丛洋, 王楠, 徐文强, 席志鹏, 谢林. 定量磁共振T2映射成像在椎间盘退变中的研究进展[J]. 分子影像学杂志, 2022, 45(3): 447-453. doi: 10.12122/j.issn.1674-4500.2022.03.28
XUE Congyang, WANG Nan, XU Wenqiang, XI Zhipeng, XIE Lin. Progress of quantitative magnetic resonance T2 mapping imaging in disc degeneration[J]. Journal of Molecular Imaging, 2022, 45(3): 447-453. doi: 10.12122/j.issn.1674-4500.2022.03.28
Citation: XUE Congyang, WANG Nan, XU Wenqiang, XI Zhipeng, XIE Lin. Progress of quantitative magnetic resonance T2 mapping imaging in disc degeneration[J]. Journal of Molecular Imaging, 2022, 45(3): 447-453. doi: 10.12122/j.issn.1674-4500.2022.03.28

定量磁共振T2映射成像在椎间盘退变中的研究进展

doi: 10.12122/j.issn.1674-4500.2022.03.28
基金项目: 

江苏省中医药科技发展项目 ZD202008

江苏省干部保健科研课题 BJ19030

详细信息
    作者简介:

    薛丛洋,在读硕士研究生,E-mail: 754118846@qq.com

    通讯作者:

    谢林,博士,主任医师,博士生导师,E-mail: xielin117@126.com

Progress of quantitative magnetic resonance T2 mapping imaging in disc degeneration

  • 摘要: 椎间盘退变是引起下腰背痛的主要原因之一,影像学的检查是诊断椎间盘退变的重要手段。传统MRI技术虽可显示椎间盘的信号强度和形态学改变,但很难客观量化椎间盘退变的程度。T2 mapping技术能够检测椎间盘内水含量、蛋白多糖含量及胶原纤维排列顺序等多种生化成分,为椎间盘退变早期临床评估提供新的方法。本文从T2 mapping与其他定量磁共振技术对比,及其与椎间盘退变分级、日本骨科学会评分、视觉模拟评分及年龄、性别等联系论述定量磁共振T2映射成像在椎间盘退变中的研究进展。

     

  • 图  1  Pfirrmann分级的T2WI影像学表现

    A~E分别表示椎间盘退变Ⅰ~Ⅴ级.

    Figure  1.  T2WI images of Pfirrmann grading.

    图  2  矢状位L3~S1的T2WI图和T2映射图

    A: 矢状位L3~S1的T2WI图; B: 矢状位腰椎间盘T2映射(L3~S1)[29].

    Figure  2.  T2WI and T2 mapping images of sagittal L3-S1 images.

    表  1  Pfirrmann分级

    Table  1.   Pfirrmann grading

    等级 髓核信号 髓核结构 髓核与纤维环的分界 椎问盘的高度
    亮白、均一 清楚 正常
    不均、有水平带 清楚 正常
    中等 灰、不均 模糊 正常-轻度减低
    中低 灰-黑、不均 模糊 正常-中度减低
    不均、黑 消失 重度减低
    下载: 导出CSV

    表  2  改良Pfirrmann分级

    Table  2.   Improved Pfirrmann grading

    分级 髓核及内层纤维信号 后方纤维内外层信号差别 椎间盘高度
    1 均匀高信号, 与脑脊液相当 明显 正常
    2 高信号(>骶骨前脂肪, <脑脊液)-髓核内低信号裂隙 明显 正常
    3 高信号(<骶骨前脂肪) 不明显 正常
    4 中等高信号(略>外层纤维环) 不明显 正常
    5 低信号(=外层纤维环) 不明显 正常
    6 低信号 不明显 椎间盘高度减小<30%
    7 低信号 不明显 椎间盘高度减小30%~ 60%
    8 低信号 不明显 椎间盘高度减小>60%
    下载: 导出CSV

    表  3  椎间盘退变组织学分级量表

    Table  3.   Histological grading scale for disc degeneration

    椎间盘成分 1分 2分 3分
    纤维环 纤维环正常, 纤维软骨板(向后呈u形, 向前略凸)纤维环无破裂, 环内任何部位无裂纹 纤维环破裂或呈裂纹样<30% 纤维环破裂或呈裂纹样>30%
    纤维环与髓核的分界 正常 最小中断 中度、重度中断
    髓核细胞结构 正常细胞, 基质凝胶状结构中有大液泡 细胞数量轻微减少, 空泡减少 细胞数量中度/重度减少(>50%), 无空泡
    髓核基质 正常的凝胶状外观 细胞外基质轻度凝结 细胞外基质中度/重度凝结
    髓核的细胞外基质 正常 细胞外基质轻度形成 中度/重度细胞外基质形成
    下载: 导出CSV

    表  4  髓核组织学退变评分量表

    Table  4.   Nucleus pulposus histological degeneration Scale

    髓核成分 1分 2分 3分
    髓核细胞 正常细胞形态, 在基质凝胶状结构中有大量的空泡 细胞数量轻度减少, 空泡轻度减少 细胞数量中度/重度减少(>50%), 无空泡
    髓核基质 正常凝胶结构 细胞外基质轻度皱缩 细胞外基质中、重度皱缩
    下载: 导出CSV
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  • 收稿日期:  2022-03-12
  • 网络出版日期:  2022-06-21
  • 刊出日期:  2022-05-20

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