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Supine and prone flexion MRI in the dynamic evaluation of the association between morphological changes of lumbar multifidus muscle and lumbar disc herniation |
SU Na1, LIU Qi2, YAN Chunli2, LIU Miao2, LU Hongjiang2, CHEN Xingcan1, 2 |
1.Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.Department of Radiology, 903 RD Hospital of PLA, Hangzhou 310013, China |
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Cite this article: |
SU Na,LIU Qi,YAN Chunli, et al. Supine and prone flexion MRI in the dynamic evaluation of the association between morphological changes of lumbar multifidus muscle and lumbar disc herniation[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2019, 49(7): 501-506.
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Abstract Objective: To evaluate the value of the difference in lumbar multifidus muscle (LMM) morphology for lumbar disc herniation (LDH) by dynamic evaluation with supine and prone flexion MRI. Methods: A total of 43 patients with LDH and 42 normal control (NC) subjects at 903 RD Hospital of PLA from March 2016 to April 2018 were enrolled in this study. All patients and healthy volunteers underwent supine and prone flexion paired lumbar MRI, including sagittal T1WI, T2WI and axial T2WI sequences. LMM morphological parameters were obtained using the ImageJ software, including the total cross-sectional area (TCSA), the functional cross-sectional area (FCSA), muscle cross-sectional area asymmetry (CSAasy), fatty infiltration ratio (FIR), and muscle morphological change between supine and prone flexion positions (S-P). The ROC curve was used to evaluate the differentiating ability of multifidus morphological parameters on LDH. Results: In both LDH and NC groups, TCSA of supine position was larger than that of prone flexion position in L3-S1 segments (P<0.001). At L3-4 segment, S-P was lower in LDH group than NC group (P<0.001); At L4-5 segment, TCSA and S-P were lower in LDH group than NC group (P<0.05), while CSAasy was higher in LDH group than NC group (P=0.015). At L5-S1 segment, TCSA, FCSA and S-P were lower in LDH group than NC group (P<0.05). The results of ROC curve showed that the classification performance of S-P (AUC=0.957) was better than other LMM morphological parameters (TCSA: AUC=0.723; FCSA: AUC=0.704; CSAasy: AUC=0.662; FIR: AUC=0.643). Conclusion: The supine and prone flexion MRI could be a useful tool to dynamically evaluate LMM morphological changes. Declined of LMM morphological change was demonstrated in LDH patients, of which contractive impairment of LMM may be an important factor.
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Received: 22 February 2019
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