Abstract

Purpose

To assess the MRI modifications of the intervertebral disc (IVD) treated by chemiodiscolysis using T2 mapping sequences.

Methods

Thirty sciatica patients (17 males, 13 females, mean age 47.52 years) were enrolled for percutaneous CT-guided O₂–O₃ chemiodiscolysis treatment. As a control group, we enrolled 30 patients who were treated by CT-guided periradicular injections. All patients were submitted to clinical (using VAS and Oswestry Disability index (ODI)) and imaging studies to evaluate the intervertebral disc area (IDA) and T2 mapping values of the IVD before and at 1-month follow-up.

Results

In the study group, pre-treatment IDA mean values were 20.47 ± 1.62 cm², with significant reduction at the follow-up (P < 0.05). Mean pre-treatment T2 relaxation time values were 38.80 ± 4.51 ms, 44.05 ± 0.91 ms, and 45.45 ± 14.11 ms for anterior annulus fibrosus, nucleus pulposus (NP), and posterior annulus fibrosus, respectively, with significant increase at the level of the NP (P < 0.05) at the follow-up. Mean pre-treatment ODI and VAS scores were 21.5 ± 10.6 and 8.5 ± 0.57, with significant improvement at the post-treatment follow-up (P < 0.05). In the control group, despite clinical improvement, we did not find significant IVA reduction nor significant T2 values change after treatment. Correlation analysis of T2 mapping relaxation time values showed significant correlation of NP T2 mapping value with both the reduction of IDA (0.81, P < 0.001) and the improvement of VAS and ODI scores (0.86, P < 0.001) at 1 month. In the control group, we did not find any statistically significant correlation.

Conclusions

T2 mapping may be a useful indicator to predict disc shrinkage and the clinical response to CT-guided O₂–O₃ injection.

中文翻译：

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使用T2映射序列评估O 2 –O 3化学溶解患者的椎间盘：具有临床相关性的仪器研究

摘要

目的

为了评估使用T2映射序列通过化学溶解处理的椎间盘（IVD）的MRI修改。

方法

研究入选了30例坐骨神经痛患者（男17例，女13例，平均年龄47.52岁），接受经皮CT引导的O ₂ -O ₃化学溶解治疗。作为对照组，我们招募了30例接受CT引导的根尖周围注射治疗的患者。所有患者均接受临床（使用VAS和Oswestry残疾指数（ODI））和影像学研究，以评估在1个月随访之前和1个月随访时椎间盘面积（IDA）和IVD的T2作图值。

结果

在研究组中，治疗前IDA平均值为20.47±1.62 cm ²，随访时明显降低（P <0.05）。前环纤维，髓核（NP）和后环纤维的平均治疗前T2弛豫时间分别为38.80±4.51 ms，44.05±0.91 ms和45.45±14.11 ms，其中环前纤维水平明显增加随访时NP（P <0.05）。治疗前ODI和VAS的平均得分分别为21.5±10.6和8.5±0.57，在治疗后的随访中有显着改善（P<0.05）。在对照组中，尽管临床上有所改善，但治疗后我们并未发现IVA明显降低，T2值也没有明显变化。T2映射弛豫时间值的相关分析显示，NP T2映射值与IDA降低（0.81，P <0.001）以及VAS和ODI分数提高（0.86，P <0.001）显着相关。在对照组中，我们没有发现任何统计学上的显着相关性。

结论

T2作图可能是预测椎间盘缩小和对CT引导的O ₂ -O ₃注射的临床反应的有用指标。