Quantitative assessment of early lumbar disc degeneration in patients with low back pain by T1rho magnetic resonance imaging

HE Min; DENG Yali; CHEN Jiafei; HOU Tianyong; CHEN Wei; ZHANG Zhiwei

doi:10.16016/j.2097-0927.202506020

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Quantitative assessment of early lumbar disc degeneration in patients with low back pain by T1rho magnetic resonance imaging

Clinical Medicine | 更新时间：2025-12-25

- Quantitative assessment of early lumbar disc degeneration in patients with low back pain by T1rho magnetic resonance imaging
- Journal of Army Medical University Vol. 47, Issue 20, Pages: 2512-2521(2025)
- 作者机构：
  
  1.重庆医科大学附属第一医院放射科，重庆
  2.陆军军医大学（第三军医大学）第一附属医院放射科重庆
  3.陆军军医大学（第三军医大学）第一附属医院骨科，重庆
- 作者简介：
- 基金信息：
  
  the Project of Postgraduate Education Teaching Reform Research of Chongqing(YJG232020)
- DOI：10.16016/j.2097-0927.202506020
  CLC： R195.1;R445.2;R681.53
- Received：07 June 2025，
  
  Revised：2025-09-24，
  
  Accepted：25 September 2025，
  
  Published：30 October 2025
- 稿件说明：
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何敏，邓亚利，陈家飞，等.T1rho磁共振技术定量评估腰痛患者椎间盘早期退行性改变［J］.陆军军医大学学报，2025，47（20）：2512-2521.DOI：10.16016/j.2097-0927.202506020.

HE M，DENG Y L，CHEN J F，et al.Quantitative assessment of early lumbar disc degeneration in patients with low back pain by T1rho magnetic resonance imaging［J］.J Army Med Univ，2025，47（20）：2512-2521.DOI：10.16016/j.2097-0927.202506020.
何敏，邓亚利，陈家飞，等.T1rho磁共振技术定量评估腰痛患者椎间盘早期退行性改变［J］.陆军军医大学学报，2025，47（20）：2512-2521.DOI：10.16016/j.2097-0927.202506020. DOI：

HE M，DENG Y L，CHEN J F，et al.Quantitative assessment of early lumbar disc degeneration in patients with low back pain by T1rho magnetic resonance imaging［J］.J Army Med Univ，2025，47（20）：2512-2521.DOI：10.16016/j.2097-0927.202506020. DOI：

摘要

目的

利用T1rho磁共振技术定量评估不同年龄、性别、节段腰痛（low back pain，LBP）患者的腰椎间盘退变（lumbar disc degeneration，LDD）特征，并分析其在椎间盘早期退行性改变中的诊断价值。

方法

采用回顾性横断面研究方法，收集2024年3月至2025年2月于陆军军医大学第一附属医院骨科就诊的LBP患者89例，其中20~29岁、30~39岁、40~49岁、50~59岁各年龄段及性别人数分布均衡。所有患者于陆军军医大学第一附属医院放射科行包含T1rho序列在内的腰椎MRI检查，2名高年资放射医师采用盲法对445个椎间盘进行Pfirrmann分级，测量髓核（nucleus pulposus，NP）T1rho值。利用Kappa检验评估2名医师的椎间盘分级一致性，使用Spearman相关系数评估Pfirrmann分级与NP-T1rho值之间的相关性，比较不同年龄、性别、腰椎节段间NP-T1rho值差异性。调整BMI和性别因素，通过偏相关分析各腰椎节段NP-T1rho值与年龄的相关性。利用受试者工作特征曲线（ROC）评估T1rho定量技术对LBP患者早期LDD的诊断性能。

结果

2名医师对不同节段的Pfirrmann分级一致性良好（Kappa系数均

0.70）。所有椎间盘NP-T1rho均值与Pfirrmann分级呈显著负相关（

-0.877

，P

0.001）。Pfirrmann Ⅰ~Ⅳ级椎间盘NP-TIrho均值依次递减（

0.001），且在Ⅱ~Ⅲ级间呈陡降趋势。20~29岁、30~39岁年龄段LBP患者在Pfirrmann Ⅰ、Ⅱ级别中NP-T1rho均值均显著高于40~49岁、50~59岁年龄段（

0.05），男性LBP患者在Pfirrmann Ⅰ级别中的NP-T1rho均值显著大于女性（

=0.006）。上腰段（L1~L4）椎间盘中，男性NP-T1rho均值显著大于女性（

=0.025），且各年龄段NP-T1rho均值随年龄增大依次递减，差异具有统计学意义（

0.05）。除L5/S1节段外，各节段NP-T1rho均值与年龄之间呈显著负相关（

=-0.548~-0.349，

0.001）。椎间盘NP-T1rho均值在Ⅰ、Ⅱ级别之间曲线下面积（AUC）为0.824（95%

：0.772~0.876），Ⅱ、Ⅲ级之间AUC为0.978（95%

：0.964~0.992）。

结论

T1rho磁共振技术可准确定量评估腰椎间盘早期退变，79.87 ms的NP-T1rho值为Ⅱ级与Ⅲ级之间的重要阈值。

Abstract

Objective

To quantitatively evaluate age-

sex-

and segment-related characteristics of lumbar disc degeneration (LDD) in patients with low back pain (LBP) using T1rho MRI

and assess its diagnostic value in early-stage disc degeneration.

Methods

A retrospective cross-sectional study was conducted on 89 LBP patients (balanced distribution across ages 20~29

30~39

40~49

50~59 years and genders) admitted in Department of Orthopedics of First Affiliated Hospital of Army Medical University from March 2024 to February 2025. All patients underwent lumbar MRI including T1rho sequences. Two senior radiologists performed blinded Pfirrmann grading on 445 intervertebral discs and measured T1rho values of the nucleus pulposus (NP). Kappa test was used to evaluate the inter-observer agreement of Pfirrmann grading

and Spearman correlation coefficient was employed to analyze the correlation between Pfirrmann grade and NP-T1rho value. Disc degeneration characteristics were compared across different ages

sexes

and spinal segments. After adjusting for body mass index (BMI) and gender

partial correlation analysis was used to assess the correlation between NP-T1rho value of each lumbar segment and age. Receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic performance of T1rho quantification for early LDD in LBP patients.

Results

Good inter-observer agreement was observed in Pfirrmann grading across segments

with a Kappa coefficient of

0.70. The NP-T1rho values of all NP were in a strong negative correlation with Pfirrmann grades (

=-0.877

0.001). The NP-T1rho values were progressively decreased from Pfirrmann gradesⅠ to Ⅳ (

0.001)

with a steep decline between gradesⅡ and Ⅲ. The patients aged 20~29 and 30~39 years showed significantly higher NP-T1rho values in Pfirrmann grades Ⅰ and Ⅱ discs when compared with those aged 40~49 and 50~59 years (

0.05). The males had significantly higher mean NP-T1rho values in grade I than the females (

=0.006). In the upper spinal segments (L1~L4)

the males exhibited significantly higher mean NP-T1rho value than the females (

=0.025)

and NP-T1rho value was decreased obviously with increase of age across all age groups (

0.05). Except L5/S1 segments

NP-T1rho value and age in all spinal segments had significant negative correlations (

=-0.548~-0.349

0.001). The area under the curve (AUC) for distinguishing grade Ⅰ from Ⅱ discs was 0.824 (95%

: 0.772~0.876)

and for grades Ⅱ from Ⅲ was 0.978 (95%

: 0.964~0.992).

Conclusion

T1rho MRI provides accurate quantitative assessment of early lumbar disc degeneration in LBP patients

with an NP-T1rho value of 79.87 ms serving as a discriminative threshold between grade Ⅱ and grade Ⅲ.

关键词

Keywords

references

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State Key Laboratory of Trauma and Chemical Poisoning， Department of Special War Wound， Army Medical Center of PLA/Daping Hospital of Third Military Medical University

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国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室3

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