高海拔地区硬膜外脂肪增多症磁共振成像诊断

doi:10.13491/j.issn.1004-714X.2024.04.014

中国辐射卫生

2024, Vol. 33

Issue (4): 435-439,446 DOI: 10.13491/j.issn.1004-714X.2024.04.014

论著

本期目录 | 过刊浏览 | 高级检索

高海拔地区硬膜外脂肪增多症磁共振成像诊断

周立娟¹, 文永仓², 张根生², 石威¹, 谢友扬¹, 张全成², 钟井松¹, 储伟¹

1. 江苏省无锡惠山区人民医院影像科，江苏无锡 214000;
2. 青海省海东市平安区中医医院，青海海东 810666

MRI diagnosis of spinal epidural lipomatosis in high-altitude areas

ZHOU Lijuan¹, WEN Yongcang², ZHANG Gensheng², SHI Wei¹, XIE Youyang¹, ZHANG Quancheng², ZHONG Jingsong¹, CHU Wei¹

1. Department of Imaging, Huishan District People’s Hospital, Wuxi 214000 China;
2. Haidong Ping ’an District Hospital of Traditional Chinese Medicine, Haidong 810666 China

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (948 KB) HTML ( )
输出: BibTeX | EndNote (RIS)

摘要目的分析高海拔地区椎管内硬膜外脂肪增多症（SEL）患者磁共振（MRI）图像，探究硬膜外脂肪厚度的最佳诊断界值。方法回顾性纳入于2021年1月1日—2022年12月31日在海东市平安区中医医院因腰背部疼痛行腰骶部MRI检查的患者。比较SEL组与非SEL组在T12/L1至L5/S1节段椎管内硬膜外脂肪厚度差异，评价各椎体节段水平不同截断值下的诊断效能。运用t检验、Mann-Whitney U检验、χ2检验或修正χ2检验进行统计学分析。以受试者操作特征（ROC）曲线下面积评价其效能。使用DeLong检验比较两者ROC曲线下面积差异。结果本研究最终纳入SEL组60例、非SEL组310例，共计370例。两组间年龄、性别、身高、体重及BMI差异均无统计学意义（P均 > 0.05）。在不同椎体节段水平，SEL组患者硬膜外脂肪厚度均显著高于非SEL组，差异有统计学意义（P均 < 0.05）。从T12/L1至L5/S1水平椎管内硬膜外脂肪厚度的SEL诊断截断值分别为2.23、4.25、4.85、5.57、7.21、8 mm；基于L5/S1水平硬膜外脂肪厚度的MRI诊断SEL的AUC值最大，为0.945（95%CI：0.916～0.966，P < 0.001）。以L5/S1水平硬膜外脂肪厚度 > 8 mm来诊断SEL最准确，AUC值为0.931（95%CI：0.901～0.955，P < 0.001）、敏感度为95.0%、特异度为91.3%；其AUC值明显高于其他截断值，且差异存在统计学意义（P均 < 0.05）。结论 SEL患者椎管内硬膜外脂肪明显增多，当L5/S1水平硬膜外脂肪厚度 > 8 mm可以为诊断SEL提供更有效、更准确的参考价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	周立娟
	文永仓
	张根生
	石威
	谢友扬
	张全成
	钟井松
	储伟

关键词 ：磁共振成像, 脊柱, 脂肪增多症, 高海拔地区, 诊断价值

收稿日期: 2024-03-07

PACS:

R445.2

基金资助:青海省海东市科技局项目（2021-HDKJ-Y7）；江苏大学2021年临床医学科技发展基金（JYL2021129）

通讯作者: 储伟，E-mail：tianyahaijiao003@163.com E-mail: tianyahaijiao003@163.com

作者简介: 周立娟（1993—），女，江苏无锡人，硕士研究生，住院医师，主要从事心血管、骨肌系统影像诊断。E-mail：1559552725@qq.com

引用本文:

周立娟, 文永仓, 张根生, 石威, 谢友扬, 张全成, 钟井松, 储伟. 高海拔地区硬膜外脂肪增多症磁共振成像诊断[J]. 中国辐射卫生, 2024, 33(4): 435-439,446.
ZHOU Lijuan, WEN Yongcang, ZHANG Gensheng, SHI Wei, XIE Youyang, ZHANG Quancheng, ZHONG Jingsong, CHU Wei. MRI diagnosis of spinal epidural lipomatosis in high-altitude areas. Chinese Journal of Radiological Health, 2024, 33(4): 435-439,446.

链接本文:

http://www.zgfsws.com/CN/10.13491/j.issn.1004-714X.2024.04.014 或 http://www.zgfsws.com/CN/Y2024/V33/I4/435

[1] Patel AJ, Sellin J, Ehni BL, et al. Spontaneous resolution of spinal epidural lipomatosis[J]. J Clin Neurosci, 2013, 20（11）: 1595-1597.
[2] Quint DJ, Boulos RS, Sanders WP, et al. Epidural lipomatosis[J]. Radiology, 1988, 169（2）: 485-490.
[3] Fujita N, Ishihara S, Michikawa T, et al. Negative impact of spinal epidural lipomatosis on the surgical outcome of posterior lumbar spinous-splitting decompression surgery: a multicenter retrospective study[J]. Spine J, 2019, 19（12）: 1977-1985.
[4] Kim YS, Ju CI, Kim SW, et al. Cauda Equina syndrome caused by idiopathic epidural lipomatosis[J]. Korean J Spine, 2015, 12（4）: 272-274.
[5] Akhaddar A, Ennouali H, Gazzaz M, et al. Idiopathic spinal epidural lipomatosis without obesity: a case with relapsing and remitting course[J]. Spinal Cord, 2008, 46（3）: 243-244.
[6] Al-Khawaja D, Seex K, Eslick GD. Spinal epidural lipomatosis-a brief review[J]. J Clin Neurosci, 2008, 15（12）: 1323-1326.
[7] Ferlic PW, Mannion AF, Jeszenszky D, et al. Patient-reported outcome of surgical treatment for lumbar spinal epidural lipomatosis[J]. Spine J, 2016, 16（11）: 1333-1341.
[8] Kim K, Mendelis J, Cho W. Spinal epidural lipomatosis: a review of pathogenesis, characteristics, clinical presentation, and management[J]. Global Spine J, 2019, 9（6）: 658-665.
[9] Kniprath K, Farooque M. Drastic weight reduction decrease in epidural fat and concomitant improvement of neurogenic claudicatory symptoms of spinal epidural lipomatosis[J]. Pain Med, 2017, 18（6）: 1204-1206.
[10] Yildirim B, Puvanesarajah V, An HS, et al. Lumbosacral epidural lipomatosis: a retrospective matched case-control database study[J]. World Neurosurg, 2016, 96: 209-214.
[11] Kumar K, Nath RK, Nair CP, et al. Symptomatic epidural lipomatosis secondary to obesity. Case report[J]. J Neurosurg, 1996, 85（2）: 348-350.
[12] 葛宇曦, 秦方晖, 岳建国, 等. 椎管内硬膜外脂肪增多症的MR I诊断标准初探[J]. 实用放射学杂志，2016，32（12）：1970-1972.
Ge YX, Qin FH, Yue JG, et al. To preliminary investigate the standard diagnosis of spinal epidural lipomatosis on MRI[J]. J Pract Radiol, 2016, 32（12）: 1970-1972.
[13] Fujita N, Hosogane N, Hikata T, et al. Potential involvement of obesity-associated chronic inflammation in the pathogenesis of idiopathic spinal epidural lipomatosis[J]. Spine (Phila Pa 1976), 2016, 41(23): E1402-E1407. DOI: 10.1097/BRS.0000000000001646.
[14] Abe T, Miyazaki M, Ishihara T, et al. Spinal epidural lipomatosis is associated with liver fat deposition and dysfunction[J]. Clin Neurol Neurosurg, 2019, 185: 105480.
[15] Sugaya H, Tanaka T, Ogawa T, et al. Spinal epidural lipomatosis in lumbar magnetic resonance imaging scans[J]. Orthopedics, 2014, 37（4）: e362-e366.
[16] Theyskens NC, Paulino Pereira NR, Janssen SJ, et al. The prevalence of spinal epidural lipomatosis on magnetic resonance imaging[J]. Spine J, 2017, 17（7）: 969-976.
[17] Ishihara S, Fujita N, Azuma K, et al. Spinal epidural lipomatosis is a previously unrecognized manifestation of metabolic syndrome[J]. Spine J, 2019, 19（3）: 493-500.
[18] Al-Omari AA, Phukan RD, Leonard DA, et al. Idiopathic spinal epidural lipomatosis in the lumbar spine[J]. Orthopedics, 2016, 39（3）: 163-168.
[19] Zając-Gawlak I, Kłapcińska B, Kroemeke A, et al. Associations of visceral fat area and physical activity levels with the risk of metabolic syndrome in postmenopausal women[J]. Biogerontology, 2017, 18（3）: 357-366.