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。
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.
关键词
腰椎 /
磁共振成像
Key words
Lumbar vertebrae /
Magnetic resonance imaging
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基金
辽宁省自然科学基金指导计划（编号2019-ZD-0794）。
