基于MRI探讨腹部脂肪厚度与腰椎间盘退变的相关性

目的：基于磁共振（MRI）T2加权像探讨腹部脂肪厚度与腰椎间盘退变的相关性。方法：收集2008年10月-2013年9月在温州医科大学附属第二医院住院行术前腰椎间盘MRI检查的患者1 108例。在T2加权像上测量腹部各径距包括腹部直径（AD）、正中矢状径（SAD）、腹部皮下脂肪厚度（VST）、背部皮下脂肪厚度（DST），并用改良的Pfirrmann分级标准对各腰椎间盘退变程度进行评分，采用spearman相关及有序logistic回归分析各径距与腰椎间盘退变的相关性。结果：spearman相关分析显示，女性SAD、AD与腰椎间盘退变总分均呈显著正相关（r=0.20，P＜0.001；r=0.19，P＜0.001）；男性VST与腰椎间盘退变总分呈负相关（r=-0.10，P=0.01）。有序logistic回归分析显示，女性SAD、AD增加腰椎间盘退变的风险（OR=1.14，95%CI：1.08～1.20，P＜0.001；OR=1.15，95%CI：1.08～1.23，P＜0.001）；男性VST降低腰椎间盘退变的风险（OR=0.70，95%CI：0.55～0.89，P=0.003）。结论：女性SAD、AD和男性VST与腰椎间盘退变密切相关，基于MRI的腹部脂肪各项径距可作为预测腰椎间盘退变的指标之一。

Correlation between abdominal adipose tissue thickness and lumbar disc degeneration: A study based on magnetic resonance imaging

Objective: To investigate the correlation between abdominal adipose tissue thickness and lumbar disc degeneration. Methods: A total of 1 108 inpatients were enrolled from the Second Affiliated Hospital of Wenzhou Medical University between October 2008 and September 2013. Parameters of abdominal adipose tissue thickness based on MRI included abdominal diameter (AD), sagittal diameter (SAD), ventral subcutaneous thickness (VST), and dorsal subcutaneous thickness (DST). Improved Pfirrmann grading system was adopted to evaluate the degree of lumbar disc degeneration. Results: Spearman correlation analysis revealed that SAD and AD had significant associations with disc degeneration score sum (r=0.20, P<0.001; r=0.19, P<0.001) in females. There was negative correlation between VST and disc degeneration score sum (r=-0.10, P=0.01) in males. Ordinal logistic regression showed that SAD (OR=1.14, 95%CI: 1.08～1.20, P<0.001) and AD (OR=1.15, 95%CI: 1.08～1.23, P<0.001) were risk factors of disc degeneration in females; VST (OR=0.70, 95%CI: 0.55～0.89, P=0.003) decreased the risk of disc degeneration in males. Conclusion: AD, SAD and VST are associated with lumbar disc degeneration, and parameters of abdominal adipose tissue thickness based on MRI may be early markers for screening lumbar disc degeneration.