Skip to main content
Erschienen in: Skeletal Radiology 7/2018

01.03.2018 | Scientific Article

Texture analysis of paraspinal musculature in MRI of the lumbar spine: analysis of the lumbar stenosis outcome study (LSOS) data

verfasst von: Manoj Mannil, Jakob M. Burgstaller, Arjun Thanabalasingam, Sebastian Winklhofer, Michael Betz, Ulrike Held, Roman Guggenberger

Erschienen in: Skeletal Radiology | Ausgabe 7/2018

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate association of fatty infiltration in paraspinal musculature with clinical outcomes in patients suffering from lumbar spinal stenosis (LSS) using qualitative and quantitative grading in magnetic resonance imaging (MRI).

Materials and methods

In this retrospective study, texture analysis (TA) was performed on postprocessed axial T2 weighted (w) MR images at level L3/4 using dedicated software (MaZda) in 62 patients with LSS. Associations in fatty infiltration between qualitative Goutallier and quantitative TA findings with two clinical outcome measures, Spinal stenosis measure (SSM) score and walking distance, at baseline and regarding change over time were assessed using machine learning algorithms and multiple logistic regression models.

Results

Quantitative assessment of fatty infiltration using the histogram TA feature “mean” showed higher interreader reliability (ICC 0.83–0.97) compared to the Goutallier staging (κ = 0.69–0.93). No correlation between Goutallier staging and clinical outcome measures was observed. Among 151 TA features, only TA feature “mean” of the spinotransverse group showed a significant but weak correlation with worsened SSM (p = 0.046). TA feature “S(3,3) entropy” showed a significant but weak association with worsened WD over 12 months (p = 0.046).

Conclusion

MR TA is a reproducible tool to quantitatively assess paraspinal fatty infiltration, but there is no clear association with the clinical outcome in asymptomatic LSS patients.
Literatur
1.
Zurück zum Zitat Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA. 2010;303(13):1259–65.CrossRefPubMedPubMedCentral Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA. 2010;303(13):1259–65.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Waddell G. Low back pain: a twentieth century health care enigma. Spine (Phila Pa 1976). 1996;21(24):2820–5.CrossRef Waddell G. Low back pain: a twentieth century health care enigma. Spine (Phila Pa 1976). 1996;21(24):2820–5.CrossRef
4.
Zurück zum Zitat Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15 Suppl 2:S192–300.CrossRefPubMed Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15 Suppl 2:S192–300.CrossRefPubMed
5.
Zurück zum Zitat Savage RA, Whitehouse GH, Roberts N. The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males. Eur Spine J. 1997;6(2):106–14.CrossRefPubMedPubMedCentral Savage RA, Whitehouse GH, Roberts N. The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males. Eur Spine J. 1997;6(2):106–14.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–6.CrossRefPubMed Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–6.CrossRefPubMed
7.
Zurück zum Zitat Beattie PF, Meyers SP, Stratford P, Millard RW, Hollenberg GM. Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance imaging. Spine (Phila Pa 1976). 2000;25(7):819–28.CrossRef Beattie PF, Meyers SP, Stratford P, Millard RW, Hollenberg GM. Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance imaging. Spine (Phila Pa 1976). 2000;25(7):819–28.CrossRef
8.
Zurück zum Zitat Rantanen J, Hurme M, Falck B, Alaranta H, Nykvist F, Lehto M, et al. The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation. Spine (Phila Pa 1976). 1993;18(5):568–74.CrossRef Rantanen J, Hurme M, Falck B, Alaranta H, Nykvist F, Lehto M, et al. The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation. Spine (Phila Pa 1976). 1993;18(5):568–74.CrossRef
9.
Zurück zum Zitat Leinonen V, Maatta S, Taimela S, Herno A, Kankaanpaa M, Partanen J, et al. Impaired lumbar movement perception in association with postural stability and motor- and somatosensory-evoked potentials in lumbar spinal stenosis. Spine (Phila Pa 1976). 2002;27(9):975–83.CrossRef Leinonen V, Maatta S, Taimela S, Herno A, Kankaanpaa M, Partanen J, et al. Impaired lumbar movement perception in association with postural stability and motor- and somatosensory-evoked potentials in lumbar spinal stenosis. Spine (Phila Pa 1976). 2002;27(9):975–83.CrossRef
10.
Zurück zum Zitat Sebro R, O’Brien L, Torriani M, Bredella MA. Assessment of trunk muscle density using CT and its association with degenerative disc and facet joint disease of the lumbar spine. Skelet Radiol. 2016;45(9):1221–6.CrossRef Sebro R, O’Brien L, Torriani M, Bredella MA. Assessment of trunk muscle density using CT and its association with degenerative disc and facet joint disease of the lumbar spine. Skelet Radiol. 2016;45(9):1221–6.CrossRef
11.
Zurück zum Zitat Kalichman L, Hodges P, Li L, Guermazi A, Hunter DJ. Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study. Eur Spine J. 2010;19(7):1136–44.CrossRefPubMed Kalichman L, Hodges P, Li L, Guermazi A, Hunter DJ. Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study. Eur Spine J. 2010;19(7):1136–44.CrossRefPubMed
12.
Zurück zum Zitat Keller A, Gunderson R, Reikeras O, Brox JI. Reliability of computed tomography measurements of paraspinal muscle cross-sectional area and density in patients with chronic low back pain. Spine (Phila Pa 1976). 2003;28(13):1455–60. Keller A, Gunderson R, Reikeras O, Brox JI. Reliability of computed tomography measurements of paraspinal muscle cross-sectional area and density in patients with chronic low back pain. Spine (Phila Pa 1976). 2003;28(13):1455–60.
13.
Zurück zum Zitat Winklhofer S, Held U, Burgstaller JM, Finkenstaedt T, Bolog N, Ulrich N, et al. Degenerative lumbar spinal canal stenosis: intra- and inter-reader agreement for magnetic resonance imaging parameters. Eur Spine J. 2017;26(2):353–61.CrossRefPubMed Winklhofer S, Held U, Burgstaller JM, Finkenstaedt T, Bolog N, Ulrich N, et al. Degenerative lumbar spinal canal stenosis: intra- and inter-reader agreement for magnetic resonance imaging parameters. Eur Spine J. 2017;26(2):353–61.CrossRefPubMed
14.
Zurück zum Zitat Betz M, Burgstaller JM, Held U, Andreisek G, Steurer J, Porchet F, et al. Influence of paravertebral muscle quality on treatment efficacy of epidural steroid infiltration or surgical decompression in lumbar spinal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data—a Swiss prospective multi-center cohort study. Spine (Phila Pa 1976). 2017;42(23):1792–8. https://doi.org/10.1097/BRS.0000000000002233.CrossRef Betz M, Burgstaller JM, Held U, Andreisek G, Steurer J, Porchet F, et al. Influence of paravertebral muscle quality on treatment efficacy of epidural steroid infiltration or surgical decompression in lumbar spinal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data—a Swiss prospective multi-center cohort study. Spine (Phila Pa 1976). 2017;42(23):1792–8. https://​doi.​org/​10.​1097/​BRS.​0000000000002233​.CrossRef
15.
Zurück zum Zitat Gillies RJ, Kinahan PE, Hricak H. Radiomics: images are more than pictures, they are data. Radiology. 2016;278(2):563–77.CrossRefPubMed Gillies RJ, Kinahan PE, Hricak H. Radiomics: images are more than pictures, they are data. Radiology. 2016;278(2):563–77.CrossRefPubMed
16.
Zurück zum Zitat Aerts HJ, Velazquez ER, Leijenaar RT, Parmar C, Grossmann P, Carvalho S, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun. 2014;5:4006.PubMedPubMedCentralCrossRef Aerts HJ, Velazquez ER, Leijenaar RT, Parmar C, Grossmann P, Carvalho S, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun. 2014;5:4006.PubMedPubMedCentralCrossRef
17.
Zurück zum Zitat Sogawa K, Nodera H, Takamatsu N, Mori A, Yamazaki H, Shimatani Y, et al. Neurogenic and myogenic diseases: quantitative texture analysis of muscle US data for differentiation. Radiology. 2017;160826 Sogawa K, Nodera H, Takamatsu N, Mori A, Yamazaki H, Shimatani Y, et al. Neurogenic and myogenic diseases: quantitative texture analysis of muscle US data for differentiation. Radiology. 2017;160826
18.
Zurück zum Zitat Hainc N, Stippich C, Stieltjes B, Leu S, Bink A. Experimental texture analysis in glioblastoma: a methodological study. Invest Radiol. 2017;52(6):367–73.CrossRefPubMed Hainc N, Stippich C, Stieltjes B, Leu S, Bink A. Experimental texture analysis in glioblastoma: a methodological study. Invest Radiol. 2017;52(6):367–73.CrossRefPubMed
19.
Zurück zum Zitat Ingrisch M, Schneider MJ, Norenberg D. Negrao de Figueiredo G, Maier-Hein K, Suchorska B, et al. Radiomic analysis reveals prognostic information in T1-weighted baseline magnetic resonance imaging in patients with glioblastoma. Invest Radiol. 2017;52(6):360–6.CrossRefPubMed Ingrisch M, Schneider MJ, Norenberg D. Negrao de Figueiredo G, Maier-Hein K, Suchorska B, et al. Radiomic analysis reveals prognostic information in T1-weighted baseline magnetic resonance imaging in patients with glioblastoma. Invest Radiol. 2017;52(6):360–6.CrossRefPubMed
20.
Zurück zum Zitat Hwang IP, Park CM, Park SJ, Lee SM, McAdams HP, Jeon YK, et al. Persistent pure ground-glass nodules larger than 5 mm: differentiation of invasive pulmonary adenocarcinomas from Preinvasive lesions or minimally invasive adenocarcinomas using texture analysis. Invest Radiol. 2015;50(11):798–804.CrossRefPubMed Hwang IP, Park CM, Park SJ, Lee SM, McAdams HP, Jeon YK, et al. Persistent pure ground-glass nodules larger than 5 mm: differentiation of invasive pulmonary adenocarcinomas from Preinvasive lesions or minimally invasive adenocarcinomas using texture analysis. Invest Radiol. 2015;50(11):798–804.CrossRefPubMed
21.
Zurück zum Zitat Pickles MD, Lowry M, Gibbs P. Pretreatment prognostic value of dynamic contrast-enhanced magnetic resonance imaging vascular, texture, shape, and size parameters compared with traditional survival indicators obtained from locally advanced breast cancer patients. Invest Radiol. 2016;51(3):177–85.CrossRefPubMed Pickles MD, Lowry M, Gibbs P. Pretreatment prognostic value of dynamic contrast-enhanced magnetic resonance imaging vascular, texture, shape, and size parameters compared with traditional survival indicators obtained from locally advanced breast cancer patients. Invest Radiol. 2016;51(3):177–85.CrossRefPubMed
22.
Zurück zum Zitat Rachidi M, Marchadier A, Gadois C, Lespessailles E, Chappard C, Benhamou CL. Laws’ masks descriptors applied to bone texture analysis: an innovative and discriminant tool in osteoporosis. Skelet Radiol. 2008;37(6):541–8.CrossRef Rachidi M, Marchadier A, Gadois C, Lespessailles E, Chappard C, Benhamou CL. Laws’ masks descriptors applied to bone texture analysis: an innovative and discriminant tool in osteoporosis. Skelet Radiol. 2008;37(6):541–8.CrossRef
23.
Zurück zum Zitat Hofmann FC, Neumann J, Heilmeier U, Joseph GB, Nevitt MC, McCulloch CE, et al. Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative. Skelet Radiol. 2018;47(1):93–106.CrossRef Hofmann FC, Neumann J, Heilmeier U, Joseph GB, Nevitt MC, McCulloch CE, et al. Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative. Skelet Radiol. 2018;47(1):93–106.CrossRef
24.
Zurück zum Zitat Ulrich NH, Burgstaller JM, Held U, Winklhofer S, Farshad M, Pichierri G, et al. The influence of single-level versus multilevel decompression on the outcome in multisegmental lumbar spinal stenosis: analysis of the lumbar spinal outcome study (LSOS) data. Clin Spine Surg. 2017;Dec;30(10):E1367–75. Ulrich NH, Burgstaller JM, Held U, Winklhofer S, Farshad M, Pichierri G, et al. The influence of single-level versus multilevel decompression on the outcome in multisegmental lumbar spinal stenosis: analysis of the lumbar spinal outcome study (LSOS) data. Clin Spine Surg. 2017;Dec;30(10):E1367–75.
25.
Zurück zum Zitat Aichmair A, Burgstaller JM, Schwenkglenks M, Steurer J, Porchet F, Brunner F, et al. Cost-effectiveness of conservative versus surgical treatment strategies of lumbar spinal stenosis in the Swiss setting: analysis of the prospective multicenter lumbar stenosis outcome study (LSOS). Eur Spine J. 2017;26(2):501–9.CrossRefPubMed Aichmair A, Burgstaller JM, Schwenkglenks M, Steurer J, Porchet F, Brunner F, et al. Cost-effectiveness of conservative versus surgical treatment strategies of lumbar spinal stenosis in the Swiss setting: analysis of the prospective multicenter lumbar stenosis outcome study (LSOS). Eur Spine J. 2017;26(2):501–9.CrossRefPubMed
26.
Zurück zum Zitat Burgstaller JM, Schuffler PJ, Buhmann JM, Andreisek G, Winklhofer S, Del Grande F, et al. Is there an association between pain and magnetic resonance imaging parameters in patients with lumbar spinal stenosis? Spine (Phila Pa 1976). 2016;41(17):E1053–62.CrossRef Burgstaller JM, Schuffler PJ, Buhmann JM, Andreisek G, Winklhofer S, Del Grande F, et al. Is there an association between pain and magnetic resonance imaging parameters in patients with lumbar spinal stenosis? Spine (Phila Pa 1976). 2016;41(17):E1053–62.CrossRef
27.
Zurück zum Zitat Bresnahan LE, Smith JS, Ogden AT, Quinn S, Cybulski GR, Simonian N, et al. Assessment of paraspinal muscle cross-sectional area following lumbar decompression: minimally invasive versus open approaches. Clin Spine Surg. 2017;30(3):E162–68.CrossRefPubMed Bresnahan LE, Smith JS, Ogden AT, Quinn S, Cybulski GR, Simonian N, et al. Assessment of paraspinal muscle cross-sectional area following lumbar decompression: minimally invasive versus open approaches. Clin Spine Surg. 2017;30(3):E162–68.CrossRefPubMed
28.
Zurück zum Zitat Stucki G, Liang MH, Fossel AH, Katz JN. Relative responsiveness of condition-specific and generic health status measures in degenerative lumbar spinal stenosis. J Clin Epidemiol. 1995;48(11):1369–78.CrossRefPubMed Stucki G, Liang MH, Fossel AH, Katz JN. Relative responsiveness of condition-specific and generic health status measures in degenerative lumbar spinal stenosis. J Clin Epidemiol. 1995;48(11):1369–78.CrossRefPubMed
29.
Zurück zum Zitat Stucki G, Daltroy L, Liang MH, Lipson SJ, Fossel AH, Katz JN. Measurement properties of a self-administered outcome measure in lumbar spinal stenosis. Spine (Phila Pa 1976). 1996;21(7):796–803.CrossRef Stucki G, Daltroy L, Liang MH, Lipson SJ, Fossel AH, Katz JN. Measurement properties of a self-administered outcome measure in lumbar spinal stenosis. Spine (Phila Pa 1976). 1996;21(7):796–803.CrossRef
30.
Zurück zum Zitat Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78–83. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78–83.
31.
Zurück zum Zitat Battaglia PJ, Maeda Y, Welk A, Hough B, Kettner N. Reliability of the Goutallier classification in quantifying muscle fatty degeneration in the lumbar multifidus using magnetic resonance imaging. J Manip Physiol Ther. 2014;37(3):190–7.CrossRef Battaglia PJ, Maeda Y, Welk A, Hough B, Kettner N. Reliability of the Goutallier classification in quantifying muscle fatty degeneration in the lumbar multifidus using magnetic resonance imaging. J Manip Physiol Ther. 2014;37(3):190–7.CrossRef
32.
Zurück zum Zitat Crawford RJ, Cornwall J, Abbott R, Elliott JM. Manually defining regions of interest when quantifying paravertebral muscles fatty infiltration from axial magnetic resonance imaging: a proposed method for the lumbar spine with anatomical cross-reference. BMC Musculoskelet Disord. 2017;18(1):25.CrossRefPubMedPubMedCentral Crawford RJ, Cornwall J, Abbott R, Elliott JM. Manually defining regions of interest when quantifying paravertebral muscles fatty infiltration from axial magnetic resonance imaging: a proposed method for the lumbar spine with anatomical cross-reference. BMC Musculoskelet Disord. 2017;18(1):25.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Szczypinski PM, Strzelecki M, Materka A, Klepaczko A. MaZda: a software package for image texture analysis. Comput Methods Prog Biomed. 2009;94(1):66–76.CrossRef Szczypinski PM, Strzelecki M, Materka A, Klepaczko A. MaZda: a software package for image texture analysis. Comput Methods Prog Biomed. 2009;94(1):66–76.CrossRef
34.
Zurück zum Zitat Collewet G, Strzelecki M, Mariette F. Influence of MRI acquisition protocols and image intensity normalization methods on texture classification. Magn Reson Imaging. 2004;22(1):81–91.CrossRefPubMed Collewet G, Strzelecki M, Mariette F. Influence of MRI acquisition protocols and image intensity normalization methods on texture classification. Magn Reson Imaging. 2004;22(1):81–91.CrossRefPubMed
35.
Zurück zum Zitat Tabari A, Torriani M, Miller KK, Klibanski A, Kalra MK, Bredella MA. Anorexia nervosa: analysis of trabecular texture with CT. Radiology. 2016;160970 Tabari A, Torriani M, Miller KK, Klibanski A, Kalra MK, Bredella MA. Anorexia nervosa: analysis of trabecular texture with CT. Radiology. 2016;160970
36.
Zurück zum Zitat Kursa MB, Rudnicki WR. Feature selection with the Boruta package. J Stat Softw. 2010;36(11):1–13.CrossRef Kursa MB, Rudnicki WR. Feature selection with the Boruta package. J Stat Softw. 2010;36(11):1–13.CrossRef
37.
Zurück zum Zitat Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20(1):37–46.CrossRef Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20(1):37–46.CrossRef
38.
Zurück zum Zitat Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed
39.
Zurück zum Zitat Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69–71.PubMedPubMedCentral Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69–71.PubMedPubMedCentral
40.
Zurück zum Zitat Aggarwal N, Agrawal RK. First and second order statistics features for classification of magnetic resonance brain images. J Signal Inf Proces. 2012;3(2):146–53. Aggarwal N, Agrawal RK. First and second order statistics features for classification of magnetic resonance brain images. J Signal Inf Proces. 2012;3(2):146–53.
41.
Zurück zum Zitat Park MJ, Cho JM, Jeon KN, Bae KS, Kim HC, Choi DS, et al. Mass and fat infiltration of intercostal muscles measured by CT histogram analysis and their correlations with COPD severity. Acad Radiol. 2014;21(6):711–7.CrossRefPubMed Park MJ, Cho JM, Jeon KN, Bae KS, Kim HC, Choi DS, et al. Mass and fat infiltration of intercostal muscles measured by CT histogram analysis and their correlations with COPD severity. Acad Radiol. 2014;21(6):711–7.CrossRefPubMed
42.
Zurück zum Zitat Gloor M, Fasler S, Fischmann A, Haas T, Bieri O, Heinimann K, et al. Quantification of fat infiltration in oculopharyngeal muscular dystrophy: comparison of three MR imaging methods. J Magn Reson Imaging. 2011;33(1):203–10.CrossRefPubMed Gloor M, Fasler S, Fischmann A, Haas T, Bieri O, Heinimann K, et al. Quantification of fat infiltration in oculopharyngeal muscular dystrophy: comparison of three MR imaging methods. J Magn Reson Imaging. 2011;33(1):203–10.CrossRefPubMed
43.
Zurück zum Zitat North American Spine Society. Diagnosis and treatment of degenerative lumbar spinal stenosis: evidence-based clinical guidelines for multidisciplinary spine care. Burr Ridge, IL: North American Spine Society; 2011. North American Spine Society. Diagnosis and treatment of degenerative lumbar spinal stenosis: evidence-based clinical guidelines for multidisciplinary spine care. Burr Ridge, IL: North American Spine Society; 2011.
44.
Zurück zum Zitat Gassman EE, Powell SM, Kallemeyn NA, Devries NA, Shivanna KH, Magnotta VA, et al. Automated bony region identification using artificial neural networks: reliability and validation measurements. Skelet Radiol. 2008;37(4):313–9.CrossRef Gassman EE, Powell SM, Kallemeyn NA, Devries NA, Shivanna KH, Magnotta VA, et al. Automated bony region identification using artificial neural networks: reliability and validation measurements. Skelet Radiol. 2008;37(4):313–9.CrossRef
45.
Zurück zum Zitat Yanik B, Keyik B, Conkbayir I. Fatty degeneration of multifidus muscle in patients with chronic low back pain and in asymptomatic volunteers: quantification with chemical shift magnetic resonance imaging. Skelet Radiol. 2013;42(6):771–8.CrossRef Yanik B, Keyik B, Conkbayir I. Fatty degeneration of multifidus muscle in patients with chronic low back pain and in asymptomatic volunteers: quantification with chemical shift magnetic resonance imaging. Skelet Radiol. 2013;42(6):771–8.CrossRef
Metadaten
Titel
Texture analysis of paraspinal musculature in MRI of the lumbar spine: analysis of the lumbar stenosis outcome study (LSOS) data
verfasst von
Manoj Mannil
Jakob M. Burgstaller
Arjun Thanabalasingam
Sebastian Winklhofer
Michael Betz
Ulrike Held
Roman Guggenberger
Publikationsdatum
01.03.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 7/2018
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-018-2919-3

Weitere Artikel der Ausgabe 7/2018

Skeletal Radiology 7/2018 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.