DCE-MRI参数联合IFIT1基因对腰椎间盘突出患者椎间盘退变程度的评估价值

探讨DCE-MRI参数及IFIT1基因对腰椎间盘突出症(LDH)患者椎间盘退变(IDD)程度的评估价值。随机选取确诊的66例LDH患者作为研究对象,根据改良Pfirrmann分级法将患者分为2组:轻中度IDD(Ⅰ~Ⅲ级)组(46例)和重度IDD(Ⅳ~Ⅴ级)组20例。通过DCE-MRI检查考察患者的K-trans值,采用日本骨科学会评分(JOA)评估腰椎功能,采用视觉模拟评分法(VAS)评估腰部疼痛,采用RT-PCR检测外周血单个核细胞(PBMC)中IFIT1的mRNA表达。轻中度IDD组的K-trans值显著低于重度IDD组。轻中度IDD组患者PBMC中的IFIT1 mRNA相对表达量显著低于重度IDD组。K-trans值与PBMC中的IFIT1 mRNA水平和VAS评分正相关,与JOA评分负相关(P<0.05)。PBMC中的IFIT1 mRNA水平与VAS评分正相关,与JOA评分负相关(P<0.05)。K-trans值和PBMC中的IFIT1 mRNA水平联合诊断重度IDD的AUC值、敏感性和特异性分别为0.991、91.3%和100.0%,AUC值和特异性均高于单独诊断。DCE-MRI检查中的K-trans值联合PBMC中的IFIT1 mRNA水平可用于LDH患者IDD程度的诊断。

The Evaluation Value of DCE-MRI Parameters Combined with IFIT1 Gene on the Degree of Disc Degeneration in Patients with Lumbar Disc Herniation

The paper explored the value of DCE-MRI parameters and IFIT1 gene in evaluating the degree of intervertebral disc degeneration(IDD) in patients with lumbar intervertebral disc herniation(LDH). 66 patients with LDH diagnosed were randomly selected as the research objects, and the patients were divided into 2 groups according to the modified Pfirrmann classification method: mild to moderate IDD(grade Ⅰ-Ⅲ) group(46 cases) and severe IDD(grade Ⅳ-Ⅴ) group(20 cases). The K-trans value of the patient was examined by DCE-MRI, the Japanese Orthopedic Association Score(JOA) was used to assess lumbar function, the visual analogue scale(VAS) was used to assess waist pain, and RT-PCR was used to detect the expression of IFIT1 mRNA in peripheral blood mononuclear cells(PBMC). The K-trans value of the mild to moderate IDD group was significantly lower than that of the severe IDD group.The relative expression of IFIT1 mRNA in PBMC of patients with mild to moderate IDD group was significantly lower than that of severe IDD group.K-trans value was positively correlated with IFIT1 mRNA level in PBMC and VAS score,and negatively correlated with JOA score(P<0.05).The IFIT1 mRNA level in PBMC was positively correlated with the VAS score,and negatively correlated with the JOA score(P<0.05).The AUC value,sensitivity and specificity of the combined diagnosis of severe IDD with K-trans value and IFIT1 mRNA level in PBMC were 0.991,91.3% and 100.0%,respectively,and the AUC value and specificity were higher than those of single diagnosis.The K-trans value in DCE-MRI combined with the IFIT1 mRNA level in PBMC can be used to diagnose the degree of IDD in LDH patients.