腰椎CT矢状面屈曲角、终板屈曲深度和双侧腰大肌横断面积差值诊断腰椎间盘突出症(LDH)的价值及与退变程度的关系

doi:10.7517/issn.1674-0475.201017

影像科学与光化学 ›› 2021, Vol. 39 ›› Issue (3): 386-390.DOI: 10.7517/issn.1674-0475.201017

腰椎CT矢状面屈曲角、终板屈曲深度和双侧腰大肌横断面积差值诊断腰椎间盘突出症(LDH)的价值及与退变程度的关系

王少锋¹, 孟小庆², 吴占勇¹, 高峰¹

1. 华北医疗健康集团邢台总医院, 河北邢台 054000;
2. 河北省眼科医院, 河北邢台 054000

收稿日期:2020-10-17 出版日期:2021-05-15 发布日期:2021-05-17
通讯作者: 吴占勇

The Value of Lumbar CT Sagittal Flexion Angle, End Plate Flexion Depth and the Difference of Bilateral Psoas Major Muscle Cross-sectional Area in the Diagnosis of LDH and the Relationship with the Degeneration

WANG Shaofeng¹, MENG Xiaoqing², WU Zhanyong¹, GAO Feng¹

1. North China Medical & Health Group Xingtai General Hospital, Xingtai 054000, Hebei, P. R. China;
2. Hebei Eye Hospital, Xingtai 054000, Hebei, P. R. China

Received:2020-10-17 Online:2021-05-15 Published:2021-05-17

摘要/Abstract

摘要： 本研究的目的是探讨腰椎矢状面屈曲角、终板屈曲深度和双侧腰大肌横断面积差值诊断腰椎间盘突出症（LDH）的价值及与椎间盘退变程度的关系。选取LDH患者120例作为观察组，同时选取体检健康者100例作为对照组，均给予腰椎CT检查。实验结果显示，观察组L₃~S₁平均终板屈曲深度、平均矢状面屈曲角、平均腰大肌横断面积与对照组比较，差异有统计学意义（P<0.05）；观察组Pfirrmann分级Ⅳ~Ⅴ级的患者L₃~S₁平均终板屈曲深度、平均矢状面屈曲角、平均腰大肌横断面积差值与Ⅱ~Ⅲ级患者比较，差异有统计学意义（P<0.05）；L₃~S₁平均终板屈曲深度、矢状面屈曲角、腰大肌横断面积差值诊断Pfirrmann分级Ⅳ~Ⅴ级的ROC曲线下面积分别为0.601、0.890和0.771。本研究证实矢状面屈曲角、终板屈曲深度、双侧腰大肌横断面积差值与LDH患者椎间盘退变程度有一定关系，诊断椎间盘退变程度有一定价值。

关键词: 腰椎CT, 矢状面屈曲角, 终板屈曲深度, 双侧腰大肌横断面积差值, 腰椎间盘突出症

Abstract: The purpose of this study was to investigate the value of sagittal lumbar flexion angle, end plate flexion depth and the difference of cross-sectional area of bilateral psoas major muscle in the diagnosis of lumbar disc herniation (LDH), as well as the relationship with the degeneration. We selected 120 cases of LDH patients as the observation group, and 100 healthy people as the control group. The Lumbar CT examination was performed on both groups. The results showed that there were statistically significant differences between the observation group and the control group in the following items:the average endplate buckling depth, the average sagittal plane buckling angle and the average psoas major cross-sectional area (L₃-S₁). Compared with patients of Pfirrmann grading Ⅱ-Ⅲ in observation group, the average depth of the end plate buckling of L₃-S₁ had statistically significant 386 differences with those of patients in Pfirrmann grading Ⅳ-Ⅴ, as well as the average sagittal buckling angle and the average psoas major cross sectional area (P<0.05). The area under the ROC curve of Pfirrmann grade Ⅳ-Ⅴ diagnosed by the three parameters were 0.701, 0.890 and 0.771. This study confirmed that Sagittal curvature angle, end plate flexion depth and the difference of cross-sectional area of bilateral psoas major muscle are related to the degree of intervertebral disc degeneration in patients with LDH, which has certain value in the diagnosis of intervertebral disc degeneration.

Key words: lumbar CT, sagittal flexion angle, end plate flexion depth, bilateral psoas major muscle cross-sectional area difference, lumbar disc herniation

王少锋, 孟小庆, 吴占勇, 高峰. 腰椎CT矢状面屈曲角、终板屈曲深度和双侧腰大肌横断面积差值诊断腰椎间盘突出症(LDH)的价值及与退变程度的关系[J]. 影像科学与光化学, 2021, 39(3): 386-390.

WANG Shaofeng, MENG Xiaoqing, WU Zhanyong, GAO Feng. The Value of Lumbar CT Sagittal Flexion Angle, End Plate Flexion Depth and the Difference of Bilateral Psoas Major Muscle Cross-sectional Area in the Diagnosis of LDH and the Relationship with the Degeneration[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(3): 386-390.

参考文献

[1] Kanno H, Aizawa T Hahimoto K, et al. Minimally invasive discectomy for lumbar disc herniation:current concepts, surgical techniques, and outcomes[J]. International Orthopaedics, 2019,43(4):917-922.
[2] Ohrt-Nissen S, Fritz B G, Walbom J, et al. Bacterial biofilms:a possible mechanism for chronic infection in patients with lumbar disc herniation-a prospective proof-of-concept study using fluorescence in situ hybridization[J]. Apmis, 2018,126(5):440-447.
[3] Shin E H, Cho K J, Kim Y T, et al. Risk factors for recurrent lumbar disc herniation after discectomy[J]. International Orthopaedics, 2019,43(4):963-967.
[4] Duran S, Cavusoglu M, Hatipoglu H G, et al. Association between measures of vertebral endplate morphology and lumbar intervertebral disc degeneration[J]. Canadian Association of Radiologists Journal, 2017,68(2):210-216.
[5] Kenichi K, Katsumi H, Yoshihiro M, et al. Effect of cartila-ginous endplates on extruded disc resorption in lumbar disc herniation[J]. Plos One, 2018,13(4):e0195946.
[6] Wang J, Sun W, Bond A, et al. Patients with idiopathic endplate inflammation displayed aberrant Th17 responses resulting in proinflammatory monocyte activation[J]. Experimental Cell Research, 2018,363(1):33-38.
[7] 尹逊屹, 祁全. 腰椎间盘退行性改变研究进展[J]. 国际骨科学杂志, 2020,41(2):35-39.
[8] Richards S J G, Senadeera S C, Frizelle F A. Sarcopenia, as assessed by psoas cross-sectional area, is predictive of adverse postoperative outcomes in patients undergoing colorectal cancer surgery[J]. Diseases of the Colon & Rectum, 2020,63(6):807-815.
[9] 胥少汀, 葛宝丰, 徐印坎. 实用骨科学(第3版)(精)[M]. 北京:人民军医出版社, 2005.
[10] Pfirrmann C W, Metzdorf A, Zanetti M, et al. Magnetic resonance classification of lumbar intervertebral disc degeneration[J]. Spine, 2001,26(17):1873-1878.
[11] 丁浚哲, 孔超, 孙祥耀,等. 腰椎间盘突出症患者下腰椎终板矢状面形态特征[J]. 中国脊柱脊髓杂志, 2018,28(10):881-887.
[12] 刘少强, 叶小伟, 梁珪清, 等. 脊柱骨盆矢状面形态与青少年腰椎间盘突出症的关系研究[J]. 中国中医骨伤科杂志, 2018,26(5):48-52.
[13] 郑勇明, 董海波. 腰椎间盘突出症患者严重程度与CT影像学特征的相关性分析[J]. 中华全科医学, 2019,7(3):447-450.
[14] 丁浚哲, 鲁世保, 孙祥耀, 等. 椎体终板参与腰椎间盘退变机制及临床意义的研究进展[J]. 中国骨与关节杂志, 2019,8(6):434-438.
[15] 宋基伟, 李宏国, 胡学昱, 等. 下腰痛青年官兵椎间高度指数与腰椎间盘突出的关系研究[J]. 西北国防医学杂志, 2020,227(5):29-34.
[16] Ella B, Sara S, Leonid K, et al. Cross-sectional area of lumbar spinal muscles and vertebral endplates:a secondary analysis of 91 computed tomography images of children aged 2-20[J]. Journal of Anatomy, 2018,233(3):358-369.
[17] 张小刚, 张军, 周涛, 等. 腰椎间盘突出症患者突出椎间盘与邻近椎间盘退变的MRI表现分析[J]. 实用临床医药杂志, 2018,22(21):154-156, 159.
[18] 汪洋, 查云飞, 邢栋. 腰椎旁肌肉脂肪含量与椎间盘退变关系的定量MRI研究[J]. 磁共振成像, 2018,9(11):29-34.
[19] 倪婷, 徐磊, 冯阳, 等. 腰椎终板Modic改变与椎间盘退变对应关系及二者与下腰痛关系的分析[J]. 南京医科大学学报(自然科学版), 2019,39(2):79-83.

腰椎CT矢状面屈曲角、终板屈曲深度和双侧腰大肌横断面积差值诊断腰椎间盘突出症(LDH)的价值及与退变程度的关系

The Value of Lumbar CT Sagittal Flexion Angle, End Plate Flexion Depth and the Difference of Bilateral Psoas Major Muscle Cross-sectional Area in the Diagnosis of LDH and the Relationship with the Degeneration

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