椎间盘退变与相邻椎体血流动力学DC E-M RI 改变的相关性

目的：运用磁共振动态增强成像（DCE‐M RI）技术定量研究椎间盘退变与其相邻椎体血流动力学的相关性。方法收集15例患者（共50个椎间盘）进行3．0T DCE‐M RI扫描，将患者腰椎间盘根据Pfirrmann分级分为正常组（共17个椎间盘）及退变组（共33个椎间盘），测量感兴趣区（ROI）血流灌注定量参数：血液渗透到血管外间隙速率（Ktrans ）、血容积（BV）、血流速（BF）。结果正常组椎间盘上缘椎体 Ktrans 、BV、BF三者均值分别为（0．0362±0．0112）min－1，（4．81±1．17） mL／100 mL ，（5．68±1．55） mL · min－1·100mL －1，下缘椎体三者均值分别为（0．042±0．0129）min－1，（5．03±0．797）mL／100mL，（6．02±1．28）mL·min－1·100 mL －1；退变组椎间盘上缘椎体Ktrans 、BV、BF三者均值分别为（0．0304±0．0112）min－1，（4．22±1．03） mL／100 mL ，（4．73±1．38）mL·min－1·100mL－1，下缘椎体三者均值分别为（0．0338±0．0125）min－1，（4．07±0．940）mL／100mL，（4．72±1．43）mL· min－1·100 mL －1。统计分析发现：（1）正常组椎间盘上缘椎体与下缘椎体3个定量参数Ktrans 、BV、BF未见明显统计学差异（t值分别为－0．98、－0．479、0．533，P＞0．05）。（2）退变组椎间盘上缘与下缘椎体3个定量参数值Ktrans 、BV、BF未见明显统计学差异（ t值分别为－0．906、0．497、0．013，P＞0．05）。（3）正常组椎间盘与退变组椎间盘邻近椎体3个血流定量参数值有显著统计学差异（t值分别为－2．26、－3．01、－2．99，P＜0．05）。结论 DCE‐MRI表明退变椎间盘相邻椎体较正常椎间盘相邻椎体血流灌注减少，椎间盘退变与其相邻椎体血供减少有明显相关性。

DCE-MRI assessment of adjacent vertebral blood perfusion of degenerated lumbar discs

Objective To analyze the correlation of intervertebral disc degeneration with the blood perfusion of its adjacent border of vertebral body by dynamic contrast‐enhanced MRI (DCE‐MRI) .Methods 3 .0T DCE‐MRI examinations were performed in 15 patients (50 discs) .Intervertebral discs from L1 to L5 were classified to normal group(17 discs) and degeneration group(33 discs) based on the Pfirrmann grading system .The DCE‐MRI pharmaeokinetic parameters of the region of interest(ROI):volume transfer constant (Ktrans ) ,blood volume(BV) and blood flow (BF) were obtained .Independent sample t test was used to compare normal group and de‐generation group .Results In normal group (n=17) ,the mean Ktrans ,BV and BF were (0 .036 2 ± 0 .011 2)min-1 ,(4 .81 ± 1 .17) mL/100 mL ,(5 .68 ± 1 .55) mL · min-1 · 100 mL -1 for the superior border of vertebral body ,and (0 .042 ± 0 .012 9)min-1 ,(5 .03 ± 0 .797) mL/100 mL ,(6 .02 ± 1 .28) mL · min-1 · 100 mL -1 for the inferior border of vertebral body .In degeneration group (n=33) ,the mean Ktrans ,BVand BF were (0 .030 4 ± 0 .011 2)min-1 ,(4 .22 ± 1 .03) mL/100 mL ,(4 .73 ± 1 .38) mL · min-1 · 100 mL-1 for the superior border of vertebral body ,and (0 .033 8 ± 0 .012 5) min-1 ,(4 .07 ± 0 .940) mL/100 mL ,(4 .72 ± 1 .43) mL · min-1 · 100 mL -1 for the inferior border of vertebral body .By statistical analysis :(1)There were no significant differences between superior border and inferior border of vertebral body in Ktrans ,BV and BF in normal group(t= -0 .98 ,-0 .479 ,0 .533 respectively ,P>0 .05 ) .(2)There were no significant differences between superior border and inferior border of vertebral body in K trans ,BV and BF in degeneration group(t= -0 .906 ,0 .497 ,0 .013 respectively ,P>0 .05) .(3)There were significant differences between normal group and degeneration group in Ktrans ,BV and BF(t= -2 .26 ,-3 .01 ,-2 .99 respectively ,P<0 .05) .Conclusion The bone marrow per‐fusion in degeneration group is decreased when compared to normal group with dynamic contrast‐enhanced MRI .Intervertebral disc degeneration correlates with the loss of its blood supply .