MRI影像学在游泳运动员腰椎间盘突出病情评估与疗效评价中的应用

doi:10.7517/issn.1674-0475.220822

摘要/Abstract

摘要： 本文探究MRI影像学在游泳运动员腰椎间盘突出症(LDH)病情评估与疗效评价中的应用价值。选取72例游泳运动员LDH患者,均进行MRI检查获取MRI参数[髓核(NP)区T2值、纤维环(AF)区T2值],比较不同病情程度患者的一般资料、日本骨科学会评分(JOA)、视觉模拟评分法(VAS)评分及MRI参数。结果显示,JOA评分、NP区T2值、AF区T2值比较,重度患者小于中度患者,中度患者小于轻度患者;VAS评分比较,重度患者大于中度患者,中度患者大于轻度患者(P＜0.05);NP区、AF区T2值与LDH病情程度、VAS评分呈负相关,与JOA评分呈正相关(P＜0.05);治疗前与治疗2周后NP区ΔT2值、AF区ΔT2值,以及联合评价疗效差的曲线下面积(AUC)分别为0.753、0.814、0.931。MRI参数NP区T2值、AF区T2值与LDH病情程度相关,且在疗效评价方面具有良好的应用价值。

关键词: 游泳运动员, 腰椎间盘突出症, 磁共振成像, 病情, 疗效

Abstract: This study explored the application value of MRI imaging in the condition evaluation and efficacy evaluation of lumbar disc herniation (LDH) in swimmers. Seventy-two swimmers with LDH were selected, and all underwent MRI examination to obtain MRI parameters [nucleus pulposus (NP) area T2 value,annulus fibrosus (AF) area T2 value]. Compared to the general data, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) score and MRI parameters of patients with different Severity of disease. The results showed that the comparison of JOA score, NP area T2 value, and AF area T2 value showed that severe patients were less than moderate patients, and moderate patients were less than mild patients. Compared with VAS scores, severe patients were greater than moderate patients, and moderate patients were greater than mild patients (P<0.05). The T2 value in NP area and AF area was negatively correlated with the severity of LDH and VAS score, and positively correlated with JOA score (P＜0.05). The ΔT2 value of NP area, the ΔT2 value of AF area, and the area under the curve (AUC) of combined evaluation of poor efficacy before treatment and after 2 weeks of treatment were 0.753, 0.814, and 0.931, respectively. The T2 values of NP area and AF area of MRI parameters are related to the severity of LDH, and have good application value in the evaluation of curative effect.

Key words: swimmers, lumbar disc herniation, MRI, condition, curative effect

杜会玲, 刘长坯. MRI影像学在游泳运动员腰椎间盘突出病情评估与疗效评价中的应用[J]. 影像科学与光化学, 2022, 40(6): 1581-1585.

DU Huiling, LIU Changpi. The Application of MRI Imaging in the Condition Evaluation and Curative Effect Evaluation of Lumbar Disc Herniation in Swimmers[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1581-1585.

参考文献

[1] Lomax M,Kapus J,Brown P I,et al. Impact of weekly swimming training distance on the ergogenicity of inspiratory muscle training in well-trained youth swimmers[J]. Journal of Strength and Conditioning Research,2019,33(8):2185-2193.
[2] 包颖. 游泳运动员腰椎退行性病变康复手段个案分析[J]. 当代体育科技,2021,11(9):35-37.
[3] 陈桂材. 四川省跳水运动员损伤特征与腰、腕慢性损伤防治及康复[D]. 成都:成都体育学院,2019.
[4] 李学洪,佟恒博,刘敏. CT多平面三维重建技术和MRI扫描对腰椎间盘突出症诊断准确性的对比分析[J]. 影像科学与光化学,2020,38(4):713-717.
[5] 王之平,吴伟,廖国政,等. 磁共振T2-mapping成像在早期膝关节骨性关节炎诊断中的应用价值[J]. 中国医学计算机成像杂志,2014,20(1):46-49.
[6] 朱守艳,王鹏,凌斌,等. MR T2*-mapping定量评估猕猴膝关节骨性关节炎软骨损伤的应用研究[J]. 实用放射学杂志,2022,38(8):1362-1366.
[7] 中华医学会骨科学分会脊柱外科学组,中华医学会骨科学分会骨科康复学组. 腰椎间盘突出症诊疗指南[J]. 中华骨科杂志,2020,40(8):477-487.
[8] 黄孟华,林孙枝,翁迪贵,等. 曲马多对腰椎间盘突出症患者疼痛和生活质量的影响[J]. 中国临床康复,2004,8(29):6294-6295.
[9] Goh G S,Soh R C C,Yue W M,et al. Determination of the patient acceptable symptom state for the Japanese Orthopaedic Association Score in patients undergoing anterior cervical discectomy and fusion for cervical spondylotic myelopathy[J]. The Spine Journal,2020,20(11):1785-1794.
[10] Chiarotto A,Maxwell L J,Ostelo R W,et al. Measurement properties of visual analogue scale,numeric rating scale,and pain severity subscale of the brief pain inventory in patients with low back pain:A systematic review[J]. The Journal of Pain,2019,20(3):245-263.
[11] 赵红义,王金贵,周翔,等. 腰椎间盘突出症疗效评价研究[J]. 河南中医,2014,34(2):330-333.
[12] Kaneoka K,Shimizu K,Hangai M K,et al. Lumbar intervertebral disk degeneration in elite competitive swimmers:A case control study[J]. The American Journal of Sports Medicine,2007,35(8):1341-1345.
[13] 高振锋. 64层螺旋CT与1.5T磁共振成像在诊断消化系统肿瘤的优势评价[J]. 中国药物与临床,2019,19(9):1435-1436.
[14] Grüneboom A,Kling L,Christiansen S,et al. Next-generation imaging of the skeletal system and its blood supply[J]. Nature Reviews Rheumatology,2019,15(9):533-549.
[15] 邓兴,姚红艳,陈晓飞,等. 磁共振IVIM-DWI与T2 mapping技术定量评价早期腰椎间盘退行性变的对比研究[J]. 临床放射学杂志,2021,40(8):1556-1562.
[16] 冯国洋,郭龙军,王娟,等. MRI参数对腰椎间盘突出症患者椎间盘退变程度的评估价值及与JOA、VAS评分相关性[J]. 影像科学与光化学,2021,39(2):207-212.
[17] Lagerstrand K,Hebelka H,Brisby H. Low back pain patients and controls display functional differences in endplates and vertebrae measured with T2-mapping[J]. European Spine Journal,2019,28(2):234-240.
[18] Sollmann N,Weidlich D,Klupp E,et al. T2 mapping of the distal sciatic nerve in healthy subjects and patients suffering from lumbar disc herniation with nerve compression[J]. Magnetic Resonance Materials in Physics,Biology and Medicine,2020,33(5):713-724.
[19] 靳晓军,周洁,吴秋辉,等. 磁共振T2技术定量检测腰椎间盘突出症的临床应用研究[J]. 现代医用影像学,2017,26(5):1256-1258.
[20] 张鑫,刘宏炜,申敏鑫,等. 专业运动员脊柱脊髓损伤后重返赛场的研究进展[J]. 中国康复理论与实践,2020,26(10):1161-1166.
[21] 吴清英. 超声波联合牵引治疗对跳水运动员腰椎间盘突出症的疗效观察[J]. 中国体育科技,2018,54(2):121-124.