文章摘要
姚洲,黄培培,凃志鹏,等.MRI联合CT测量腰椎椎旁肌脂肪含量的初步研究.骨科,2024,15(3): 193-199.
MRI联合CT测量腰椎椎旁肌脂肪含量的初步研究
Measuring Lumbar Paraspinal Muscle Fat Content Using MRI Combined with CT
投稿时间:2024-03-01  
DOI:10.3969/j.issn.1674-8573.2024.03.001
中文关键词: 腰椎退行性疾病  椎旁肌肉  脂肪浸润  核磁共振成像  评估方法
英文关键词: Lumbar degenerative disease  Paraspinal muscle  Fat infiltration  MRI  Assessment method
基金项目:空军军医大学第一附属医院军事医学临床应用研究课题(JSYXZ10)
作者单位E-mail
姚洲 空军军医大学附属西京医院骨科西安 710032  
黄培培 空军军医大学附属西京医院骨科西安 710032  
凃志鹏 空军军医大学附属西京医院骨科西安 710032  
赵士贤 空军军医大学附属西京医院骨科西安 710032  
叶斌 空军军医大学附属西京医院骨科西安 710032  
胡学昱 空军军医大学附属西京医院骨科西安 710032 huxueyu@fmmu.edu.cn 
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中文摘要:
      目的 探讨MRI联合CT描计法、手动定义灰度阈值法测量腰椎椎旁肌脂肪含量的准确性及可行性。方法 依据纳排标准,30例门诊腰椎退变病人入组,其中男15例,女15例,年龄为(57.18±10.52)岁(29~74岁),获取其腰椎CT及MRI影像,以L5上终板水平位的椎旁肌(多裂肌和竖脊肌)为研究目标,分别采用MRI联合CT描计法(CT+MRI组)和单纯MRI描计法(单纯MRI组)定义肌肉边界,并选取同一层面水平位的T2抑制像(T2-STIR)作为阳性对照,采用ImageJ软件测量肌肉总面积、功能面积,比较各方法之间的差异;进一步测量椎旁肌的脂肪替代面积和脂肪浸润率,比较自动获取影像灰度阈值(自动阈值组)与手动定义灰度阈值(手动阈值组)对T2加权像上椎旁肌肉脂肪化测量的影响。结果 CT+MRI组的各椎旁肌肉总面积和功能面积均大于单纯MRI组,差异有统计学意义(P<0.05);CT+MRI组的椎旁肌总面积、功能面积与阳性对照组相近,单纯MRI组测量结果则明显小于阳性对照组,差异有统计学意义(P<0.05)。椎旁肌脂肪浸润评估方面,手动阈值组各椎旁肌的功能面积较大、脂肪替代面积较小,所得的脂肪浸润率较低,差异有统计学意义(P<0.05);阳性对照组的结果与手动阈值组更为接近,而与自动阈值组的结果差异较大,均有统计学意义(P<0.05)。结论 MRI联合CT描计肌肉边界、手动定义灰度阈值法,能够有效提高椎旁肌肉脂肪浸润评价的准确度。
英文摘要:
      Objective To investigate the accuracy and feasibility of MRI combined with CT scanner and manually defined gray threshold method in measuring lumbar paraspinal muscle fat content. Methods According to the inclusion and exclusion criteria, 30 patients with lumbar degeneration were enrolled in this study, including 15 males and 15 females, aged (57.18±10.52) years (29-74 years). Lumbar CT and MRI images were obtained, to investigate the paraspinal muscles (multifidus and erector spinae) in the horizontal position of the L5 endplate, define muscle boundaries using MRI combined with CT scanning (CT+MRI group) and MRI scanning alone (MRI group), respectively. T2-STIR images of the same level were selected as positive control. ImageJ software was used to measure the total muscle area and functional muscle area, and the differences between the methods were compared. Furthermore, the fat replacement area and fat infiltration rate of paraspinal muscle were measured, and the effects of automatic gray level threshold (automatic threshold group) and manual gray level threshold (manual threshold group) on the measurement of paraspinal muscle fat infiltration on T2-weighted images were compared. Results The total area and functional area of each paravertebral muscle in CT+MRI group were larger than those in MRI group, and the difference was statistically significant (P<0.05). The total area and functional area of paraspinal muscles in the CT+MRI group were similar to those in the positive control group, and the measurement results in the MRI group were significantly smaller than those in the positive control group, and the difference was statistically significant (P<0.05). In the assessment of paraspinal muscle fat infiltration, the functional area of each paraspinal muscle in the manual threshold group was larger, the fat replacement area was smaller, and the fat infiltration rate was lower, with the difference being statistically significant (P<0.05). The results of the positive control group were more similar to those of the manual threshold group, while the results of the positive control group were significantly different from those of the automatic threshold group (P<0.05). Conclusion The method of MRI combined with CT tracing muscle boundary and manually defining gray threshold can effectively improve the accuracy of the evaluation of paravertebral muscle fat infiltration.
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