腰椎间盘高度与基于Pfirrmann分数的椎间盘退化的严重程度之间的关系
Xiao-Long Chen1, Xiang-Yu Li1, Yu Wang1
1Department of Orthopaedics, Xuanwu Hospital Capital Medical University, Xicheng District, Beijing, China.
Heliyon
|October 23, 2023
概括
这项研究表明,大多数磁盘高度 (DH) 在MRI上的测量方法在评估椎间盘退化 (IVD) 中具有良好的可靠性. 严重的IVD退化 (Pfirrmann等级IV-V) 与较低的DH和更差的临床结果相关.
科学领域:
- 放射学 放射学是一门学科.
- 整形外科 整形外科 整形外科
- 脊柱外科手术 脊柱外科手术
背景情况:
- 盘高度 (DH) 对于评估椎间盘退化 (IVD) 是至关重要的.
- 皮尔曼评分系统使用基于MRI的DH变化来评估IVD.
- 不同的DH测量技术的可靠性及其与IVD严重程度的联系仍然不清楚.
研究的目的:
- 在MRI上研究各种DH测量技术的内定量和间定量可靠性.
- 评估不同DH测量方法与IVD退行性Pfirrmann分数之间的关联.
- 探索Pfirrmann分数与临床结果 (VAS,ODI) 之间的关系.
主要方法:
- 在成年患者的腰椎MRI扫描上评估了八种DH测量技术.
- 评价者内部和评价者之间的协议使用布兰德和奥尔特曼的协议限制 (LOA) 进行了评估.
- 通过使用类内相关系数 (ICC) 确定了评价者内部和评价者间的可靠性.
主要成果:
- 大多数DH测量方法显示出优异的评价者内可靠性 (ICC>0.9) 和良好的至优异的评价者间可靠性 (ICC>0.8).
- 第4方法和第5方法显示较低的体内一致性,而第5方法对后方磁盘材料长度的体内可靠性较低.
- 1-6方法在脊髓缩症患者中具有较差的评价者间可靠性.
- 与I-III等级相比,Pfirrmann等级IV-V的IVD水平观察到明显较低的DH.
- 皮尔曼等级IV-V与显著更高的视觉模拟尺度 (VAS) 和奥斯韦斯特里残疾指数 (ODI) 分数相关.
结论:
- 大多数MRI上的DH测量技术在使用标准化协议时表现出良好的可靠性.
- 测量准确度可能会受到小型解剖结构和不同的组织边界的影响.
- DH测量可以有效地区分Pfirrmann等级IV和V,严重的IVD退化与较差的临床结果相关.
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