| ObjectiveThe vertebral fat content,proteoglycan content and water content of intervertebral disc,protein macromolecular content and fat content of paravertebral muscle of adolescent idiopathic scoliosis patients were measured by quantitative magnetic resonance quantitative technique.Then we analyzed the correlation between quantitative parameters and the severity of scoliosis in order to further explore the diagnostic value of quantitative MR technology in the study of early AIS degeneration.In addition,the most correlated quantitative parameters with the severity of scoliosis and the corresponding responsible sites were analyzed and lay a theoretical foundation for further study on the etiology and progression of scoliosis.MethodsAccording to the degree of scoliosis,45 AIS subjects with primary thoracic curvature were divided into 3 groups(Group A: Cobb Angle <30°;Group B: Cobb Angle ? 30 °,? 50 °;group C: Cobb>50 °).MRI multi-parameter scanning was performed on all subjects,including T1rho-weighted images,T2 mapping and IDEAL IQ.The scan extent included vertebra,intervertebral disc and paravertebral muscle of the apical zone,upper-end zone,lower-end zone and normal zone.One-way analysis of variance were performed to compare the difference in T1 rho,T2 and FF values of tissue structures at different vertebral levels in AIS patients.Then,Pearson correlation analysis was used to analyze the correlation between the FF values of the AIS vertebrae,the T1 rho and T2 values of the intervertebral disc,and the T1 rho and FF values of the paraspinal muscle.Finally,paired sample T test was used to analyze the difference of multiple parameters between concave-convex side.Results1.In the quantitative analysis of vertebral bone marrow fat fraction by IDEAL IQ: The FF of apex vertebra between group A,B and C,and the lower end vertebra between group A and C were statistically significant(P<0.05).There was no statistically significant difference between the FF of the upper-end vertebra and the normal vertebra(P>0.05).The FF of the upper and lower end vertebra were positively correlated with the degree of lateral curvature(r=0.563,0.358,P<0.05).2.In the quantitative analysis of the nucleus pulposus and the annulus fibrosus by T1 rho mapping MR imaging:2.1 The T1 rho values of the apical nucleus pulposus between group A,B and C,the upper-end nucleus pulposus between group A and C,groups B and C,the lower-end nucleus between group A and B and group A and C,the normal nucleus pulposus between group A and C were statistically significant(P<0.05).There was no statistically significant difference in the T1 rho values of the upper-end nucleus pulposus between group A and B,lower-end nucleus pulposus between group B and C,normal nucleus pulposus between group A and B,B and C(P>0.05).The T1 rho of apex,upper end,lower end and normal nucleus pulposus were negatively correlated with the degree of lateral curvature(r=-0.798,-0.744,-0.620,-0.452,P<0.05).2.2 The T1 rho values of apex,upper-end,lower-end concave annulus fibrosus between group A and C,group B and C were statistically significant differences(P<0.05).T1 rho values of apex,the upper-end,the lower-end concave annulus fibrosus between group A and B,normal concave annulus fibrosus between group A,B and C have no statistical significance(P > 0.05).The T1 rho of concave annulus fibrosus at the apex,upper-end,lower-end and normal disc were negatively correlated with the degree of lateral curvature(r=-0.752,-0.600,-0.501,-0.371,P< 0.05).2.3 The T1 rho values of apex,upper-end,lower-end convex annulus fibrosus between group A and C,group B and C were statistically significant differences(P<0.05).T1 rho values of apex,upper-end,lower-end concave annulus fibrosus between group A and B,normal convex annulus fibrosus between group A,B and C have no statistical significance(P > 0.05).The T1 rho of convex annulus fibrosus at the apex,upper-end,lower-end and normal disc were negatively correlated with the degree of lateral curvature(-0.670,-0.552,-0.555,-0.352,P< 0.05).2.4 There were statistically significant differences in T1 rho of the concave-convex annulus fibrosus of the apex,the upper end and the lower end in different degrees of scoliosis(P<0.05).There was no statistically significant difference on the concave-convex side of normal disc(P>0.05).3.In the quantitative analysis of the nucleus pulposus and the annulus fibrosus by T2mapping:3.1 The T2 values of the apex,upper and lower nucleus pulposus between group A,B and C were statistically significant(P<0.05).The T2 value of the apex,upper and lower nucleus pulposus were negatively correlated with the degree of lateral curvature(r=-0.840,-0.753,-0.761,P< 0.05).3.2 The T2 values of the apex,upper and lower concave annulus fibrosus between group A and B,A and C were statistically significant(P<0.05).The T2 values of the apex,upper and lower concave annulus fibrosus between group B and C have no statistical significance(P > 0.05).The T2 value of the concave annulus fibrosus was negatively correlated with the degree of lateral curvature(r=-0.580,-0.612,-0.613,P< 0.05).3.3 The T2 values of the apex,upper and lower convex annulus fibrosus between group A and B,A and C were statistically significant(P<0.05).The T2 values of the apex,upper and lower convex annulus fibrosus between group B and C have no statistical significance(P > 0.05).The T2 value of the concave annulus fibrosus was negatively correlated with the degree of lateral curvature(r=-0.526,-0.545,-0.573,P< 0.05).3.4 There were statistically significant differences in T2 of the apical concave-convex annulus fibrosus between group B and C(P<0.05),while the upper and lower concave-convex annulus fibrosus have no statistical significance(P > 0.05).4.In the quantitative analysis of the paravertebral muscle by T1 rho mapping MR imaging:4.1 The T1 rho values of apical concave paravertebral muscle between group A and C,group B and C were statistically significant differences(P<0.05).T1 rho values of apical concave paravertebral muscle between group A and B,the upper-end,the lower-end and normal concave paravertebral muscle between group A,B and C have no statistical significance(P > 0.05).The T1 rho of concave paravertebral muscle at the apex were negatively correlated with the degree of lateral curvature(r=-0.388,P< 0.05).4.2 The T1 rho values of apical convex paravertebral muscle between group A and C,group B and C were statistically significant differences(P<0.05).T1 rho values of apical convex paravertebral muscle between group A and B,the upper-end,the lower-end and normal concave paravertebral muscle between group A,B and C have no statistical significance(P > 0.05).The T1 rho of concave paravertebral muscle at the apex and upper-end were positive correlated with the degree of lateral curvature(r=0.575,0.300,P< 0.05).4.3 There were statistically significant differences in T1 rho of the apical concave-convex paravertebral muscle in group B and C,and upper-end in group C(P<0.05),while other vertebral level concave-convex paravertebral muscle have no statistical significance(P >0.05).5.In the quantitative analysis of the paravertebral muscle by IDEAL IQ:5.1 The FF of apical concave paravertebral muscle between group A,B and C and the FF values of upper-end and lower-end concave paravertebral muscle between A and C were statistically significant differences(P<0.05).FF of upper-end and lower-end concave paravertebral muscle between group A and B,B and C,normal concave paravertebral muscle between group A,B and C have no statistical significance(P > 0.05).The FF of concave paravertebral muscle at the apex,upper-end,lower-end and normal were positive correlated with the degree of lateral curvature(r=0.797,0.725,0.617,0.349,P< 0.05).5.2 The FF of apical,upper-end and lower-end convex paravertebral muscle between group A and C B and C were statistically significant differences(P<0.05).FF of apical,upper-end and lower-end convex paravertebral muscle between group A and B,normal convex paravertebral muscle between group A,B and C have no statistical significance(P > 0.05).The FF of convex paravertebral muscle at the apex,upper-end,lower-end and normal were positive correlated with the degree of lateral curvature(r=0.515,0.666,0.700,0.296,P< 0.05).5.3 There were statistically significant differences in FF of the apical concave-convex paravertebral muscle in group B and C,and upper-end in group C(P<0.05),while other vertebral level concave-convex paravertebral muscle have no statistical significance(P > 0.05).Conclusion1.AIS patients with different degrees of scoliosis showed differences in tissue composition content.As the degree of scoliosis increased,the fat content of vertebral body increased.The contents of proteoglycan and water in nucleus pulposus and annulus fibrosus were decreased,and the concave side was more significant than the convex side.The proteoglycan of the paravertebral muscle increased in the convex side and decreased in the concave side,and the fat content of the paravertebral muscle increased in both sides and the concave side was significant.2.Lower end vertebra is related to the occurrence and progression of scoliosis,which should be the focus in the next stage of the study,so as to find the application of individualized treatment.3.The imaging techniques of T1 rho mapping,T2 mapping and IDEAL IQ can sensitively detect the changes of tissue composition in AIS patients. |
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