磁共振测量矢状位及轴位参数在退变性腰椎不稳中的临床价值及相关性分析

doi:10.12117/jccmi.2020.06.014

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摘要目的：探讨MRI测量腰椎矢状位及轴位参数在退变性腰椎不稳患者中的临床价值及相关性。方法：回顾性分析2018年5月—2019年7月我院退变性腰椎不稳170例和170例健康志愿者的MRI资料，两组间性别、年龄、病变节段相匹配。于T2WI矢状位MRI图像评估腰骶角大小，于T2WI轴位MRI图像评估黄韧带厚度值、小关节积液宽度、腰椎间盘退变分级和小关节退变分级，比较2组间的差异。结果：腰椎不稳组患者腰骶角、小关节积液宽度分别为（（47.92±11.11）°，1.51（0.95，1.93） mm），与对照组比较差异均有统计学意义（P均＜0.01）。两组间腰椎间盘退变分级（Z=-4.749）及小关节退变分级（Z=-11.407）比较有统计学意义（P均＜0.01）。腰椎不稳组患者黄韧带值为（2.20±1.01） mm，与对照组比较无统计学意义（P＞0.05）。腰椎不稳与腰骶角大小、小关节积液量宽度和腰椎间盘退变分级成正相关（r=0.180，P＝0.011；r=0.317，P＜0.01；r=0.258，P＜0.01），与小关节退变分级成负相关（r=-0.619，P＜0.01）。结论：退变性腰椎不稳与多种MRI参数具有相关性，与小关节积液量宽度成中等相关性，与腰骶角大小及腰椎间盘退变分级成弱相关性，与小关节退变分级成强负相关性。

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	梁译丹1
	李乐义2
	潘诗农1

关键词 ：腰椎, 磁共振成像

Abstract：Objective: To investigate the clinical value and correlation analysis of sagittal and axial parameters measured by MRI in patients with degenerative lumbar instability. Methods: MRI imaging data of 170 patients with degenerative lumbar instability and 170 normal volunteers were analyzed retrospectively, no significant differences were found in the gender, age and lesion segment between the two groups. Lumbosacral angle was measured on sagittal T2WI, while ligamentum flavum thickness, the distance of facet joint fluid and the degree of degeneration of the intervertebral disc and the facet joint were evaluated on axial T2WI, and then were compared between the two groups. Results: In degenerative lumbar instability group, lumbosacral angle and the distance of facet joint fluid was (47.92±11.11)°, 1.51(0.95, 1.93) mm respectively, and the differences between the two groups were statistically significant(all P＜0.01). Between the two groups, the degree of degeneration of the intervertebral disc and the facet joint showed significant differences(Z=-4.749, Z=-11.407, P＜0.01). In degenerative lumbar instability group, the ligamentum flavum thickness was (2.20±1.01) mm, and the differences between the two groups was not statistically significant(P＞0.05). Degenerative lumbar instability was positively correlated with lumbosacral angle and the distance of facet joint fluid and the degree of degeneration of the intervertebral disc(r=0.180, P＝0.011; r=0.317, P＜0.01; r=0.258, P＜0.01), degenerative lumbar instability was negatively correlated with the degree of degeneration of the facet joint(r=-0.619, P＜0.01). Conclusion: There were kinds of parameters which had correlation in degenerative lumbar instability; degenerative lumbar instability was moderately correlated with the distance of facet joint fluid, while degenerative lumbar instability was weakly correlated with lumbosacral angle and the degree of degeneration of the intervertebral disc. There was a significant negative correlation with the degree of degeneration of the facet joint.

Key words： Lumbar vertebrae Magnetic resonance imaging

收稿日期: 2019-10-26

PACS:	Ｒ681.57
	Ｒ445.2

基金资助:辽宁省自然科学基金指导计划（编号2019-ZD-0794）。

通讯作者: 潘诗农，中国医科大学附属盛京医院放射科，110004。E-mail：cjr.panshinong@vip.163.com

作者简介: 梁译丹（1987-），女，辽宁沈阳人，主治医师。E-mail：liangydan@126.com

引用本文:

梁译丹1，李乐义2，潘诗农1. 磁共振测量矢状位及轴位参数在退变性腰椎不稳中的临床价值及相关性分析[J]. 中国临床医学影像杂志, 2020, 31(6): 434-437.
LIANG Yi-dan1, LI Le-yi2, PAN Shi-nong1. Clinical value and correlation analysis of sagittal and axial parameters measured by MRI in degenerative lumbar instability. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(6): 434-437.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.06.014 或 http://www.jccmi.com.cn/CN/Y2020/V31/I6/434

[1]朱勇，赵宏，邱贵兴. 腰椎不稳的诊断和治疗进展[J]. 中国脊柱脊髓杂志，2009，19（2）：150-153.
[2]Panjabi MM. Clinical spinal instability and low back pain[J]. J Electromyogr Kinesiol, 2003, 13(4): 371-379.
[3]Dombrowski ME, Rynearson B, LeVasseur C, et al. ISSLS PRIZE IN BIOENGINEERING SCIENCE 2018: dynamic imaging of degenerative spondylolisthesis reveals mid-range dynamic lumbar instability not evident on static clinical radiographs[J]. Eur Spine J, 2018, 27(4): 752-762.
[4]Morita T, Yoshimoto M, Terashima Y, et al. Do we have adequate flexion-extension radiographs for evaluating instability in patients with lumbar spondylolisthesis?[J]. Spine, 2020, 45(1): 48-54.
[5]Cabraja M, Mohamed E, Koeppen D, et al. The analysis of segmental mobility with different lumbar radiographs in symptomatic patients with a spondylolisthesis[J]. Eur Spine J, 2012, 21(2): 256-261.
[6]Pitkanen MT, Manninen HI, Lindgren KA, et al. Segmental lumbar spine instability at flexion-extension radiography can be predictedby conventional radiography[J]. Clin Radiol, 2002, 57(7): 632-639.
[7]Ochia RS, Inoue N, Renner SM, et al. Three-dimensional in vivo measurement of lumbar spine segmental motion[J]. Spine, 2006, 31(18): 2073-2078.
[8]Haughton VM, Rogers B, Meyerand ME, et al. Measuring the axial rotation of lumbar vertebrae in vivo with MR imaging[J]. Am J Neuroradiol, 2002, 23(7): 1110-1116.
[9]Tarpada SP, Cho W, Chen F, et al. Utility of Supine Lateral Radiographs for Assessment of Lumbar Segmental Instability in Degenerative Lumbar Spondylolisthesis[J]. Spine, 2018, 43(18): 1275-1280.
[10]Abitbol MM. Evolution of the lumbosacral angle[J]. Am J Phys Anthropol, 1987, 72(3): 361-372.
[11]邢文华，郝利霞，霍洪军，等. 腰椎管狭窄症椎管狭窄的MRI测量及其临床意义[J]. 中国临床医学影像杂志，2014，25（9）：645-647.
[12]Pfirrmann CW, Metzdorf A, Zanetti M, et al. Magnetic resonance classification of lumbar intervertebral disc degeneration[J]. Spine, 2001, 26(17): 1873-1878.
[13]Weishaupt D, Zanetti M, Boos N, et al. MR imaging and CT inosteoarthritis of the lumbar facet joints[J]. Skeletal Radiol, 1999, 28(4): 215-219.
[14]Ellingson AM, Nuckley DJ. Altered helical axis patterns of the lumbar spine indicate increased instability with disc degeneration[J]. J Biomech, 2015, 48(2): 361-369.
[15]Axelsson P, Karlsson BS. Intervertebral mobility in the progressive degenerative process. A radiostereometric analysis[J]. Eur Spine J, 2004, 13(6): 567-572.
[16]Luk KDK, Chow DHK, Holmes A. Vertical instability in spondylolisthesis: a traction radiographic assessment technique and the principle of management[J]. Spine, 2003, 28(8): 819-827.
[17]Yoshiiwa T, Miyazaki M, Notani N, et al. Analysis of the relationship between ligamentum flavum thickening and lumbar segmental instability, disc degeneration, and facet joint osteoarthritis in lumbar spinal stenosis[J]. Asian Spine J, 2016, 10(6): 1132-1140.
[18]李浩鹏，杨保辉，张国安，等. 退行性腰椎不稳发病相关因素的临床研究[J]. 实用骨科杂志，2009，15（5）：339-341.
[19]Hipp JA, Guyer RD, Zigler JE, et al. Development of a novel radiographic measure of lumbar instability and validation using the facet fluid sign[J]. Int J Spine Surg, 2015, 9: 37.
[20]Cho Il Youp, Park Si Young, Park Jong Hoon, et al. MRI findings of lumbar spine instability in degenerative spondylolisthesis[J]. J Orthop Surg(Hong Kong), 2017, 25(2): 1-5.
[21]Chaput C, Padon D, Rush J, et al. The significance of increased fluid signal on magnetic resonance imaging in lumbar facets in relationship to degenerative spondylolisthesis[J]. Spine, 2007, 32(17): 1883-1887.
[22]Snoddy MC, Sielatycki JA, Sivaganesan A, et al. Can facet joint fluid on MRI and dynamic instability be a predictor of improvement in back pain following lumbar fusion for degenerative spondylolisthesis?[J]. Eur Spine J, 2016, 25(8): 2408-2415.
[23]郭建国，李志浩，申忠国. L5-S1间成角增大与临床相关性研究[J]. 中国医学影像技术，2008，24（S1）：173-175.
[24]毕金坤，黄卫民，杨晓凯，等. 腰骶角形态学测量及临床意义[J]. 创伤与急危重病医学，2015，3（1）：55-57.
[25]Cornips EM, Razenberg FG, Van Rhijnl W, et al. The lumbosacral angle does not reflect progressive tethered cord syndrome in children with spinal dysraphism[J]. Childs Nerv Syst, 2010, 26(12): 1757-1764.
[26]Hey HW, Lau ET, Lim JL, et al. Slump sitting X-ray of the lumbar spine is superior to the conventional flexion view in assessing lumbar spine instability[J]. Spine J, 2017, 17(3): 360-368.
[27]Chan V, Marro A, Rempel J. Determination of dynamic instability in lumbar spondylolisthesis using flexion and extension standing radiographs versus neutral standing radiograph and supine MRI[J]. J Neurosurg Spine, 2019, 26: 1-7.