Quantitative Analysis Of Early Lumbar Disc Degeneration In Young And Middle-aged People By Intravoxel Incoherent Motion In Body Diffusion-weighted Imaging

Objective To explore the predictive value of ADCslow,ADCfast and f value of IVIM-DWI sequence in early lumbar disc degeneration in young and middle-aged people by using IVIM-DWI technique as the main research method of magnetic resonance quantitative imaging(MRI).Methods This study included 45 patients with low back pain and 22 healthy volunteers(331 lumbar intervertebral discs)in our hospital from December 2020 to December 2022.The ADCslow,ADCfast and f values of all lumbar intervertebral discs were measured,and then they were divided into 3 groups according to the Pfirrmann grading standard.SPSS20.0 statistical software was used to analyze the data.The measured data are described by mean ±standard deviation(x±s),and the differences between groups are compared by single factor analysis of variance.Based on Pfirrmann grading,the difference between intervertebral disc and ADCslow,ADCfast,f value was evaluated by analysis of variance.At the same time,the receiver working characteristic(receiveroperatingcharacteristic,ROC)curve was construted to evaluate and calculate the area under the curve(AUC).The maximum tangent point of Yoden index(Youden)was Cut-off,and the corresponding sensitivity and specificity were obtained.Results(1)the consistency of ADCfast value,ADCfast value and f value of 331 intervertebral discs measured by different observers was statistically significant and good(p<0.05).(2)the ADCfast ening values of L5-S1 intervertebral discs and other intervertebral discs were statistically significant.When comparing the f values of different lumbar disc segments in the group,only the f values of L5-S1 intervertebral discs and other intervertebral discs were statistically significant,and the ADCslow values of different intervertebral disc segments were not statistically significant.(3)the ADCfast value has statistical significance in distinguishing the intervertebral disc of each group:distinguishing the intervertebral disc of the normal group(grade Ⅰ)VS early degeneration group(Ⅱ+Ⅲ grade)has a certain accuracy(AUC=0.766,sensitivity 64.2%,specificity 78.5%);distinguishing the normal group(grade I),the middle and late stage VS degeneration group(Ⅳ+Ⅴ grade)has a certain accuracy(AUC=0.822,sensitivity 67.9%,specificity 91.3%).Distinguishing early degeneration group(Ⅱ+Ⅲ grade)VS middle and late degeneration group(Ⅳ+Ⅴ grade)intervertebral disc has certain accuracy(AUC=0.779,sensitivity 62.4%,specificity 92.1%).The ADCslow value has statistical significance in distinguishing the intervertebral disc of each group:distinguishing the intervertebral disc of the normal group(grade Ⅰ)VS early degeneration group(Ⅱ+Ⅲ grade)has a certain accuracy(AUC=0.707,sensitivity 83.6%,specificity 61.0%);distinguishing the normal group(grade Ⅰ)VS middle and late stage degeneration group(Ⅳ+Ⅴ grade)intervertebral disc has certain accuracy(AUC=0.701,sensitivity 84.5%,specificity 58.6%).Distinguish early degeneration group(Ⅱ+Ⅲ grade)VS middle and late degeneration group(Ⅳ+Ⅴ grade)intervertebral disc accuracy is general(AUC=0.668,sensitivity 86.6%,specificity 51.0%).F value could not distinguish the intervertebral disc of each group,(4)there was significant difference in ADCslow,ADCfast and f value between nucleus pulposus and anterior and posterior annulus fibrosus(P<0.001),but there was no significant difference in ADCslow,ADCfast and f value between anterior and posterior annulus fibrosus(P>0.05).Conclusion 1.ADCslow and ADCfast of IVIM-DWI sequence have certain accuracy and specificity in distinguishing the early degeneration of lumbar intervertebral disc in young and middle-aged people,which provides a reliable basis for early clinical treatment.two。2.There is no significant difference in the measurement results of the same IVIM-DWI sequence images with different observations,so subjective factors have little influence on the results of IVIM-DWI examination.