Evaluating Paraspinal Back Muscles Using Computed Tomography (CT) and Magnetic Resonance Imaging (MRI): Reliability Analysis and Correlation with Intervertebral Disc Pathology
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To investigate the reliability of CT and MRI for quantitative and qualitative analyses of lumbar paraspinal muscle fatty infiltration (PSFI) and correlation of PSFI with intervertebral disc pathology. Materials and Methods: Lumbar spine CT and MRI of 36 subjects were reviewed retrospectively. Two observers independently outlined lumbar paraspinal muscles at each mid-intervertebral disc level. Paraspinal muscles on CT and MRI were graded according to the Goutallier grading system (GGS). The area, mean value, and standard deviation (SD) of the Hounsfield unit (HU) were obtained. Intervertebral discs were assessed on axial image of T2WI at each level. Correlations between qualitative and quantitative data and intervertebral disc pathology, age, and sex were evaluated. Results: Inter- and intra-observer agreements for results of GGS on MRI were substantial (κ = 0.79) and moderate (κ = 0.59), respectively. Inter- and intra-observer agreements for results of GGS on CT were almost perfect (κ = 0.88) and substantial (κ = 0.66), respectively. Quantitative measurements of HU showed almost perfect inter- and intra-observer reliabilities (κ = 0.82 and κ = 0.99, respectively). There were statistically significant correlations between intervertebral disc pathology and PSFI at L1-2, L2-3, and L4-5 levels on MRI and at L1-2 and L3-4 levels on CT. Age showed significant correlation with results of GGS at all levels on CT and MRI. Conclusion: This study showed that GGS results and HU measurements could be useful for evaluating PSFI because they showed correlations with intervertebral disc pathology results at certain levels.
Abstract
Purpose: To investigate the reliability of CT and MRI for quantitative and qualitative analyses of lumbar paraspinal muscle fatty infiltration (PSFI) and correlation of PSFI with intervertebral disc pathology. Materials and Methods: Lumbar spine CT and MRI of 36 subjects were reviewed retrospectively. Two observers independently outlined lumbar paraspinal muscles at each mid-intervertebral disc level. Paraspinal muscles on CT and MRI were graded according to the Goutallier grading system (GGS). The area, mean value, and standard deviation (SD) of the Hounsfield unit (HU) were obtained. Intervertebral discs were assessed on axial image of T2WI at each level. Correlations between qualitative and quantitative data and intervertebral disc pathology, age, and sex were evaluated. Results: Inter- and intra-observer agreements for results of GGS on MRI were substantial (κ = 0.79) and moderate (κ = 0.59), respectively. Inter- and intra-observer agreements for results of GGS on CT were almost perfect (κ = 0.88) and substantial (κ = 0.66), respectively. Quantitative measurements of HU showed almost perfect inter- and intra-observer reliabilities (κ = 0.82 and κ = 0.99, respectively). There were statistically significant correlations between intervertebral disc pathology and PSFI at L1-2, L2-3, and L4-5 levels on MRI and at L1-2 and L3-4 levels on CT. Age showed significant correlation with results of GGS at all levels on CT and MRI. Conclusion: This study showed that GGS results and HU measurements could be useful for evaluating PSFI because they showed correlations with intervertebral disc pathology results at certain levels.
참고문헌 (24)
- Wook Ha Kim, "Changes in the Cross-Sectional Area of Multifidus and Psoas in Unilateral Sciatica Caused by Lumbar Disc Herniation", 대한신경외과학회지, 50(3), pp.201~204 (2011), 대한신경외과학회
- Lonnemann ME, "A morphological comparison of the human lumbar multifidus by chemical dissection", J Man Manip Ther, 16, pp.E84~92 (2008)
- Parkkola R, "Lumbar disc and back muscle degeneration on MRI : correlation to age and body mass", J Spinal Disord, 5, pp.86~92 (1992)
- Barker KL, "Changes in the crosssectional area of multifidus and psoas in patients with unilateral back pain : the relationship to pain and disability", Spine(Phila Pa 1976)2004;, 29, pp.E515~519
- Yong-Hing K, "The pathophysiology of degenerative disease of the lumbar spine", Orthop Clin North Am, 14, pp.491~504 (1983)
- Kader DF, "Correlation between the MRI changes in the lumbar multifidus muscles and leg pain", Clin Radiol, 55, pp.145~149 (2000)
- Crawford RJ, "Rate of lumbar paravertebral muscle fat infiltration versus spinal degeneration in asymptomatic populations : an ageaggregated cross-sectional simulation study", Scoliosis Spinal Disord, 11, pp.21~ (2016)
- Crawford RJ, "Change in fatty infiltration of lumbar multifidus, erector spinae, and psoas muscles in asymptomatic adults of Asian or Caucasian ethnicities", Eur Spine J, 26, pp.3059~3067 (2017)
- Boutin RD, "Sarcopenia : current concepts and imaging implications", AJR Am J Roentgenol, 205, pp.W255~266 (2015)
- Deng CY, "Progressive sarcopenia in patients with colorectal cancer predicts survival", AJR Am J Roentgenol, 210, pp.526~532 (2018)
- Battaglia PJ, "Reliability of the Goutallier classification in quantifying muscle fatty degeneration in the lumbar multifidus using magnetic resonance imaging", J Manipulative Physiol Ther, 37, pp.190~197 (2014)
- Keller A, "Reliability of computed tomography measurements of paraspinal muscle cross-sectional area and density in patients with chronic low back pain", Spine (Phila Pa 1976), 28, pp.1455~1460 (2003)
- Schober P, "Correlation coefficients : appropriate use and interpretation", Anesth Analg, 126, pp.1763~1768 (2018)
- Cohen J, "Weighted kappa : nominal scale agreement with provision for scaled disagreement or partial credit", Psychol Bull, 70, pp.213~220 (1968)
- Bierry G, "Disorders of paravertebral lumbar muscles : from pathology to cross-sectional imaging", Skeletal Radiol, 37, pp.967~977 (2008)
- Ploumis A, "Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease", Br J Radiol, 84, pp.709~713 (2011)
- Kalichman L, "Indices of paraspinal muscles degeneration : reliability and association with facet joint osteoarthritis : feasibility study", Clin Spine Surg, 29, pp.465~470 (2016)
- Sun D, "Correlation between intervertebral disc degeneration, paraspinal muscle atrophy, and lumbar facet joints degeneration in patients with lumbar disc herniation", BMC Musculoskelet Disord, 18, pp.167~ (2017)
- Danneels LA, "CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects", Eur Spine J, 9, pp.266~272 (2000)
- Storheim K, "The effect of comprehensive group training on cross-sectional area, density, and strength of paraspinal muscles in patients sick-listed for subacute low back pain", J Spinal Disord Tech, 16, pp.271~279 (2003)
- Kalichman L, "Changes in paraspinal muscles and their association with low back pain and spinal degeneration : CT study", Eur Spine J, 19, pp.1136~1144 (2010)
- Bulcke JA, "Computed tomography of the human skeletal muscular system", Neuroradiology, 17, pp.127~136 (1979)
- Parkkola R, "Magnetic resonance imaging of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects", Spine (Phila Pa 1976), 18, pp.830~836 (1993)
- Mengiardi B, "Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers : quantification with MR spectroscopy", Radiology, 240, pp.786~792 (2006)