垂直与卧卧的腰椎MRI:研究结果是否有系统的差异,哪一个与疼痛更好地相关? 一个系统的审查
Klaus Doktor1, Henrik Wulff Christensen2, Tue Secher Jensen3
1Center for Muscle and Joint Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Chiropractic Knowledge Hub, University of Southern Denmark, Odense, Denmark; Diagnostic Center-Imaging Section and University Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Aarhus University, Denmark.
概括
在腰部疼痛 (LBP) 患者的卧床MRI相比,直立MRI显示了测量的系统差异. 虽然直立扫描可能更好地与疼痛相关,但需要更多的研究来确认临床意义.
科学领域:
- 放射学和医学成像学 医学成像学
- 整形外科 整形外科 整形外科
- 脊柱健康 脊柱健康 脊柱健康
背景情况:
- 卧床MRI是治疗腰部疼痛 (LBP) 的标准,但直立 (站立) 的MRI可以通过评估承重效应来提供优势.
- 假设表明直立的MRI揭示了参数和与疼痛/残疾相关的系统差异.
研究的目的:
- 系统地审查和总结支持或反驳关于LBP直立与卧卧MRI的假设的经验证据.
主要方法:
- 系统性文献综述 (PROSPERO ID:CRD42017048318) 关于对立式和卧式MRI观测的研究.
- 包括的研究要求至少有15名参与者 (18岁以上) 有或没有LBP/根性病变.
- 分析连续,顺序和二分式MRI参数,将观察到的差异与预先规定的期望进行比较,并评估与疼痛/残疾的相关性.
主要成果:
- 分析了19项研究 (5,082名参与者),检查了许多MRI参数.
- 躺卧和直立MRI之间观察到的差异通常与由于承重的预期保持一致.
- 有限的研究报告了与疼痛/残疾的相关性,但直立MRI显示潜在的更高的相关性.
结论:
- 卧式和直立MRI参数之间存在系统差异,支持承重假设.
- 直立MRI可能会增强与疼痛的相关性,但确的证据和临床意义需要进一步调查.
- 需要对直立MRI对临床决策和患者结果的影响进行直接研究.
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