Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: Quantification with MR spectroscopy
Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: Quantification with MR spectroscopy
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DOI：
10.1148/radiol.2403050820
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发表时间：
2006-09-01
期刊：
影响因子：
19.7
通讯作者：
Hodler, Juerg
中科院分区：
文献类型：
--
作者：
Mengiardi, Bernard;Schmid, Marius R.;Hodler, Juerg
目的：前瞻性地评估椎旁肌的脂肪含量，通过使用质子磁共振（MR）波谱在慢性下腰痛（LBP）患者和无症状志愿者匹配方面的年龄，性别和身体质量指数。材料和方法：该研究是由负责机构审查委员会批准。从每名患者和每名志愿者处获得知情同意书。采用单体素质子磁共振波谱测量25例慢性LBP患者（13例女性，12例男性;平均年龄40.5岁）和25例匹配的无症状志愿者（13例女性，12例男性;平均年龄39.8岁）的腰椎多裂肌和最长肌的脂肪含量。还对脂肪含量进行了半定量分级（0-4级）。脂肪含量和LBP持续时间、LBP强度和自评残疾之间的关系进行了评估结果：多裂肌脂肪含量平均为23.6%（95%置信区间[CI]：17.5%，29.7%）在慢性LBP患者和14.5%（95% CI：10.8%，18.3%）在志愿者（P = 0.014）。LBP患者的最长肌相应值为29.3%（95%CI：23.4%，35.3%），志愿者为26.0%（95%CI：21.9%，30.0%）（P = 0.66）。多裂肌脂肪含量的半定量分级为0的25例患者中的12例（48%）和25例志愿者中的14例（56%），1的11例（44%）患者和8例（32%）志愿者，2的2例（8%）患者和3例（12%）志愿者。9/25例（36%）患者和15/25例（60%）志愿者的背最长肌脂肪含量半定量分级为0，13例（52%）患者和9例（36%）志愿者为1，3例（12%）患者和1例（4%）志愿者为2。3级和4级均未分配给任何肌肉。患者和志愿者之间的分级差异不显著。脂肪含量和疼痛强度，疼痛持续时间，或自评disability.Conclusion之间没有显着的相关性被发现：质子磁共振波谱表现出显着较高的脂肪含量在多裂肌慢性LBP患者比无症状的志愿者。半定量分级系统未发现差异。
Purpose: To prospectively evaluate the fat content of paraspinal muscles by using proton magnetic resonance (MR) spectroscopy in patients with chronic low back pain (LBP) and in asymptomatic volunteers matched with regard to age, sex, and body mass index.Materials and Methods: The study was approved by the responsible institutional review board. Informed consent was obtained from each patient and each volunteer. Single-voxel proton MR spectroscopy was used to measure the fat content of the lumbar multifidus and longissimus muscles in 25 patients (13 women, 12 men; mean age, 40.5 years) with chronic LBP and in 25 matched asymptomatic volunteers (13 women, 12 men; mean age, 39.8 years). The fat content was also graded semiquantitatively (grades 0-4). The relationship between fat content and LBP duration, LBP intensity, and self-rated disability was assessed (Pearson correlation).Results: The mean percentage fat content of the multifidus muscle was 23.6% (95% confidence interval [CI]: 17.5%, 29.7%) in patients with chronic LBP and 14.5% (95% CI: 10.8%, 18.3%) in the volunteers (P = .014). The corresponding values for the longissimus muscle were 29.3% (95% CI: 23.4%, 35.3%) in patients with LBP and 26.0% (95% CI: 21.9%, 30.0%) in the volunteers (P = .66). The semiquantitative grading of the fat content of the multifidus muscle was 0 in 12 (48%) of 25 patients and in 14 (56%) of 25 volunteers, 1 in 11 (44%) patients and in eight (32%) volunteers, and 2 in two (8%) patients and three (12%) volunteers. The semiquantitative grading of the fat content of the longissimus muscle was 0 in nine (36%) of 25 patients and 15 (60%) of 25 volunteers, 1 in 13 (52%) patients and nine (36%) volunteers, and 2 in three (12%) patients and one (4%) volunteer. Neither grade 3 nor grade 4 was assigned to any muscle. The grading differences were not significant between patients and volunteers. No significant correlation was found between fat content and pain intensity, pain duration, or self-rated disability.Conclusion: Proton MR spectroscopy demonstrates a significantly higher fat content in the multifidus muscle in patients with chronic LBP than in asymptomatic volunteers. No difference was detected with a semiquantitative grading system.