The Research Of Metabolites In The Multifidus Muscle Of Three Lumbar Transverse Process Syndrom By ~1H-MRS

ObjectiveTo explore the Imaging indicators of the third lumbar transverse process syndrome,this study will obtain the content of Cr,Cho,Lip and its ratio in the multifidus muscle between three lumbar transverse process syndrome patients and healthy volunteers by using Magnetic Resonance Spectroscopy(~1H-MRS)and magnetic resonance imaging(MRI),which to make Imaging foundation for clinical diagnosis and curative effect of lumbar transverse process syndrome.Materials and Methods1.The choice of subjectsThere are two group,the case group and the health control group.The case group contain 59 cases of patients with three lumbar transverse process syndrome(23 males,37females,mean age 25±2.61years,range from 23 to 31years,all cases came from the Shandong Provincial Hospital).The process of diseases have been lasted for 3months to20years.At the same time,the health control group contain 69 healthy volunteers(39males,30 females,mean age 27.81±3.15years,range from 25 to 35 years,)without low back pain were randomly selected.Age(t=-0.879,p=0.381)and gender(t=-1.739,p=0.084)between groups were not different statistically.All people in this research had signed informed consents.2.Apparatus and equipmentMR images were acquired with a 1.5-T superconducting MRS(Amira;Siemens Medical Solutions,Germany)equipped with the standard body coil.The conventional and~1H-MRS sequence were included.All the subjects were carried out sagittal T1-weighted imaging(TR:604ms,TE:8.7ms),T2-weighted imaging(TR:3500ms,TE:100ms),STIR fast spin-echo MR image(TR:5610ms,TE:90ms),axial T2-weighted scan(TR:4000ms,TE:93ms),sagittal FOV:300×300mm,thickness 4.0mm,1.0mm spacing.The scan range is from the upper limb of T12to the low limb of S5.The T1WI image were positioning for 1H-MRS and the single voxel based volume localization module was used in the scan.The voxel was placed at the crack intramuscular which was on the right side of L3/4 intervertebral disc.The specific location was random selected.The parameters are as follows:STEAM,TR:1500ms,TE:30ms,acquisition:128times,scan time:200s,water suppression frequency of 35Hz,bandwidth of 1000Hz,each voxel area was 15×15×20mm,The Region of interest was located in the multifidus muscle level.Before the scan,in order to make sure that the surrounding vessel,bone,muscular fasciae and fat did not affect the signal acquisition,the study would add 6 groups of saturated zone around the the voxel.The original data was analyzed automatically using SIEMENS software,the spectrum tab of metabolites in multifidus muscle and the area under the peak of various substances will obtained.Subsequently,we will get the value of integral of metabolites based on the creatine for internal reference.3.Statistical AnalysisSPSS 19.0 statistical analysis software package was used.All the measurement data are indicated withx±s.Single-sample Levene test were used to test data normality and homogeneity of variance.Paired T test analysis was used to analyze the content differences of the materials between multifidus muscle within one group.Independent samples T Test was used to analyze the content of the materials differences in multifidus muscle between the two groups.Taking the p<0.05 as a difference,p<0.01 for the significant difference.Conclusion1.Content differences of Lip?Cr?Cho and the value of Lip/Cr and Cho/Cr between bilateral multifidus muscles within the healthy control group was not statistically significant(p>0.05);(table 1)2.Content differences of Lip?Cr?Cho and the value of Lip/Cr and Cho/Cr between bilateral multifidus muscles within the case group was not statistically significant(p>0.05);(table 2)3.Content differences of Lip(t=-13.142,p=1.9e-019)and and the value of lip/Cr(t=-8.079,p=4.6e-009)in the left side of the multifidus muscle between the case group and the healthy control group was statistically significant;Content differences of Cr?Cho and the value of Cho/Cr in the left side of multifidus muscle between the two groups was not statistically significant(p>0.05);(table 3)4.Content differences of Lip(t=-11.116.p=1.15e-019)and and the value of lip/Cr(t=-9.379,p=3.9e-014)in the right side of the multifidus muscle between the case group and the healthy control group was statistically significant;Content differences of Cr?Cho and the value of Cho/Cr in the right side of multifidus muscle between the two groups was not statistically significant(p>0.05).(table 4)ConclusionThe contents of Lip and the value of lip/Cr are differences between the case group and the healthy control group.There are higher in the multifidus muscle of the case group than in the healthy control group,whih indicated that the contents of Lip and the value of lip/Cr have been able to be the Imaging indicators for clinical diagnosis and curative effect of lumbar transverse process syndrome.