An investigation into the use of MR imaging to determine the functional cross sectional area of lumbar paraspinal muscles
An investigation into the use of MR imaging to determine the functional cross sectional area of lumbar paraspinal muscles
复制标题
DOI：
10.1007/s00586-005-0909-3
复制
发表时间：
2006-06-01
影响因子：
2.8
通讯作者：
O'Sullivan, Peter B.
中科院分区：
文献类型：
--
作者：
Ranson, Craig A.;Burnett, Angus F.;O'Sullivan, Peter B.
本研究的目的是调查使用磁共振（MR）成像和图像处理软件，以确定功能横截面积（FCSA）（从脂肪中分离的肌肉面积）的腰椎旁肌。腰椎椎旁肌的形态学测量已成为最近几项下腰痛病因学研究的焦点。然而，使用MR成像确定腰椎旁肌FCSA的可靠性和有效性尚待报道。使用相同的MR系统和扫描参数在6名受试者的L1-S1脊柱节段获得T2轴向MR扫描。使用图像分析软件手动分割瘦椎旁肌、椎体骨和肌间脂肪，以将灰度范围分配给每种组织类型发出的MR信号强度。得到的肌肉灰度范围用于确定每个扫描切片上每个椎旁肌、腰肌、腰方肌、竖脊肌和腰多裂肌的FCSA测量值。由于各种生物学、仪器和测量因素会影响MR信号强度，因此进行了灵敏度分析，以确定使用离散灰度范围计算椎旁肌FCSA的相关误差。横截面积和FCSA测量重复三次，并获得FCSA测量的可靠性指数，显示出良好的可靠性，类内相关系数（平均值=0.97，范围0.90-0.99）和%SEM（平均值= 2.6%，范围0.7-4.8%）。此外，计算了与肌肉MR信号强度的灰度范围的错误计算相关的误差，发现该误差很低，在肌肉灰度范围的上端有20个灰度单位的误差，导致测量的肌肉FCSA的误差非常小。本文提出的方法在循证康复、生物力学建模和节段惯性参数的确定等领域具有多种实际应用。
The purpose of this study was to investigate the use of magnetic resonance (MR) imaging and image processing software to determine the functional cross-sectional area (FCSA) (the area of muscle isolated from fat) of the lumbar paraspinal muscles. The measurement of the morphology of the lumbar paraspinal muscles has become the focus of several recent investigations into the aetiology of low back pain. However, the reliability and validity of determining the FCSA of the lumbar paraspinal muscles using MR imaging are yet to be reported. T2 axial MR scans at the L1-S1 spinal levels of six subjects were obtained using identical MR systems and scanning parameters. Lean paraspinal muscle, vertebral body bone and intermuscular fat were manually segmented using image analysis software to assign a grey scale range to the MR signal intensity emitted by each tissue type. The resultant grey scale range for muscle was used to determine FCSA measurements for each of the paraspinal muscles, psoas, quadratus lumborum, erector spinae and lumbar multifidus on each scan slice. As various biological, instrument and measurement factors can affect MR signal intensity, a sensitivity analysis was conducted to determine the error associated in calculating FCSA for paraspinal muscle using a discrete grey scale range. Cross-sectional area and FCSA measurements were repeated three times and reliability indices for the FCSA measurements were obtained, showing excellent reliability, intra class correlation coefficient (mean=0.97, range 0.90-0.99) and %SEM (mean=2.6%, range 0.7-4.8%). In addition, the error associated with miscalculation of the grey scale range for the MR signal intensity of muscle was calculated and found to be low with an error of 20 grey scale units at the upper end of the muscle's grey scale range resulting in a very small error in the measured muscle FCSA. The method presented in this paper has a variety of practical applications in areas such as evidence-based rehabilitation, biomechanical modelling and the determination of segmental inertial parameters.