目的 测量健康人椎旁肌影像学参数,阐明椎旁肌特点及变化规律,探究椎旁肌退变的影响因素.方法 2020年2月-11月前瞻性招募82名健康志愿者,男36名,女46名;年龄21～75岁,平均48.0岁.身高 150～183 cm,平均 165.6 cm;体质量 43～100 kg,平均 65.4 kg;身体质量指数(body mass index,BMI)16.7～32.4 kg/m2,平均23.7 kg/m2.采用MRI测量L3、L4、L5 3个层面椎旁肌(多裂肌、竖脊肌和腰大肌)影像学参数,包括相对总横截面积(relative total cross-sectional area,rtCSA)、相对脂肪横截面积(relative fatty cross-sectional area,rfCSA)、相对信号强度(relative signal intensity,rSI)及脂肪浸润比(fatty infiltration,FI).比较不同性别以及不同测量层面椎旁肌参数差异;通过Pearson或Spearman相关分析探究椎旁肌参数与年龄、身高、体质量、BMI之间的关系.结果 从L3至L5层面,多裂肌、腰大肌rtCSA、rfCSA及竖脊肌rfCSA逐渐增加,竖脊肌rtCSA逐渐减小;各椎旁肌的FI、rSI均逐渐增加.L4、L5层面各椎旁肌各参数与L3层面比较差异均有统计学意义(P＜0.05);而L4层面与L5层面比较,多裂肌rtCSA、rfCSA,竖脊肌rtCSA、FI、rSI,以及腰大肌rtCSA、rfCSA、FI差异有统计学意义(P＜0.05).女性各腰椎层面多裂肌rfCSA和FI、竖脊肌FI、腰大肌FI高于男性,腰大肌rtCSA低于男性(P＜0.05).年龄与各椎旁肌rtCSA成负相关(P＜0.05),与各椎旁肌FI及多裂肌和竖脊肌rfCSA、rSI成正相关(P＜0.05).身高与各椎旁肌rfCSA、FI成负相关(P＜0.05).结论 沿脊柱轴线从头端至尾端,椎旁肌退变程度逐渐增加;椎旁肌退变和年龄、身高、性别相关,体质量、BMI和椎旁肌退变关系需要进一步研究.
Radiographic parameters and influencing factors of paraspinal muscle degeneration in healthy people
Objective To measure the paraspinal muscle parameters,explore the characteristics of paraspinal muscles,and investigate the influence factors of paraspinal muscle degeneration in healthy people.Methods Eighty-two healthy Chinese people were prospectively recruited between February 2020 and November 2020,including 36 males and 46 females.The age ranged from 21 to 75 years,with a mean of 48.0 years.The height ranged from 150 to 183 cm,with a mean of 165.6 cm.The body mass ranged from 43 to 100 kg,with a mean of 65.4 kg.The body mass index(BMI)ranged from 16.7 to 32.4 kg/m2,with a mean of 23.7 kg/m2.Parameters of the paraspinal muscles(multifidus muscle,erector spinae muscle,and psoas major muscle)at L3,L4,and L5 levels were measured by MRI,including the relative total cross-sectional area(rtCSA),relative fatty cross-sectional area(rfCSA),relative signal intensity(rSI),and fatty infiltration(FI).The differences of paraspinal muscle parameters at different genders and different measurement levels were compared;Pearson or Spearman correlation analysis was used to explore the relationship between paraspinal muscle parameters and age,height,body mass,BMI.Results From L3 to L5 level,the rtCSA and rfCSA of multifidus muscle and psoas major muscle as well as the rfCSA of erector spinae muscle increased,while rtCSA of erector spinae muscle decreased.The FI and rSI of paraspinal muscles increased gradually.The parameters of paraspinal muscles at L4 and L5 levels were significantly different from those at L3 levels(P＜0.05).There were significant differences in rtCSA and rfCSA of multifidus muscle,rtCSA,FI,and rSI of erector spinae muscle as well as rtCSA,rfCSA,and FI of psoas major muscle between L4 and L5 levels(P＜0.05).Compared with males,the rfCSA and FI of multifidus muscle,FI of erector spinae muscle,and FI of psoas major muscle were significantly higher in females,while the rtCSA of psoas major muscle was significantly lower(P＜0.05).Age was significantly negatively correlated with rtCSA of paraspinal muscles(P＜0.05),but significantly positively correlated with FI of paraspinal muscles,rfCSA and rSI of multifidus and erector spinae muscles(P＜0.05).Height was significantly negatively correlated with rfCSA and FI of paraspinal muscles(P＜0.05).Conclusion The degree of paraspinal muscle degeneration increases gradually along the spine axis from head to tail.Paraspinal muscle degeneration is related to age,height,and gender.The relationship between the body mass,BMI and paraspinal muscle degeneration needs further study.
Multifidus muscleerector spinae musclepsoas major muscleparaspinal muscle degenerationhealthy people
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