CAJ | 학술논문

目的：探讨运动负荷对正常腰椎间盘MR扩散张量成像（DTI）中表观弥散系数（ADC）和部分各向异性（FA）的影响。方法对30例健康志愿者行常规矢状位FSE/T2WI成像及运动负荷前后DTI成像，其中男性24名，女性6名，年龄19~25岁。在MR常规T2WI序列上对腰椎间盘按Pfirrmann标准进行退变分级，利用DTI原始数据重组b0图、ADC图及FA图，测量并比较运动负荷前后ADC值、FA值的变化。统计方法使用重复测量数据的方差分析，P<0.05具有统计学意义。结果30名志愿者，观测L1~S1共计150个椎间盘，将其中27例腰椎间盘Pfirrminn分级均为Ⅱ级的受试者纳入研究。腰椎间盘平均ADC值运动负荷前为（1.99±0.18）×10-3 mm2/s，运动负荷后为（1.93±0.17）×10-3 mm2/s，较运动负荷前下降，差异具有统计学意义（P<0.05）；腰椎间盘平均FA值运动负荷前为0.155±0.059，运动负荷后为0.163±0.017，较运动负荷前升高，差异不具有统计学意义（P>0.05）。结论磁共振DTI成像可以定量分析运动负荷后腰椎间盘水分子扩散能力及各向异性程度的变化。运动负荷后，腰椎间盘ADC值下降，FA值升高，其中ADC值的变化更为敏感。
목적：탐토운동부하대정상요추간반MR확산장량성상（DTI）중표관미산계수（ADC）화부분각향이성（FA）적영향。방법대30례건강지원자행상규시상위FSE/T2WI성상급운동부하전후DTI성상，기중남성24명，녀성6명，년령19~25세。재MR상규T2WI서렬상대요추간반안Pfirrmann표준진행퇴변분급，이용DTI원시수거중조b0도、ADC도급FA도，측량병비교운동부하전후ADC치、FA치적변화。통계방법사용중복측량수거적방차분석，P<0.05구유통계학의의。결과30명지원자，관측L1~S1공계150개추간반，장기중27례요추간반Pfirrminn분급균위Ⅱ급적수시자납입연구。요추간반평균ADC치운동부하전위（1.99±0.18）×10-3 mm2/s，운동부하후위（1.93±0.17）×10-3 mm2/s，교운동부하전하강，차이구유통계학의의（P<0.05）；요추간반평균FA치운동부하전위0.155±0.059，운동부하후위0.163±0.017，교운동부하전승고，차이불구유통계학의의（P>0.05）。결론자공진DTI성상가이정량분석운동부하후요추간반수분자확산능력급각향이성정도적변화。운동부하후，요추간반ADC치하강，FA치승고，기중ADC치적변화경위민감。
Objective To investigate the effect of exercise load on apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of normal lumbar intervertebral discs in magnetic resonance (MR) diffusion tensor imaging (DTI) . Methods Thirty healthy volunteers (24 males and 6 females, aged 19 to 25 years) underwent examinations with MR T2WI and DTI of the lumbar intervertebral discs before and after exercise load. Pfirrmann grading was evaluated with T2WI, and the B0 map, ADC map and FA map were reconstructed based on the DTI data to investigate the changes in ADC and FA after exercise. Results Of the 30 volunteers (150 intervertebral discs) receiving the examination, 27 with discs of Pfirrminn grade II were included for analysis. In these 27 volunteers, the average ADC and FA before exercise were (1.99 ± 0.18) × 10- 3 mm2/s and 0.155 ± 0.059, respectively. After exercise, ADC was lowered significantly to (1.93 ± 0.17) × 10-3 mm2/s (P<0.05) and FA increased slightly to 0.1623 ± 0.017 (P>0.05). Conclusion DTI allows quantitatively analysis of the changes in water molecular diffusion and anisotropy of the lumbar intervertebral discs after exercise load, which can cause a decreased ADC and a increased FA value, and the change of ADC is more sensitive to exercise load.