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腰椎间盘退变合并腰椎终板骨软骨炎的MRI表现分析(1)
http://www.100md.com 2012年2月25日 王晖 姜飚 周航
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     [摘要] 目的 探讨腰椎间盘退变合并腰椎终板骨软骨炎的MRI表现。 方法 将本院2009年1月~2011年10月以MRI确诊的87例腰椎间盘退变合并腰椎终板骨软骨炎患者的MRI影像学资料进行回顾性分析,总结其影像学特点。 结果 87例患者共累及终板142个,其中累及单个终板7例,累及多个终板80例。Modic分型,其中Ⅰ型退变46个,Ⅱ型退变75个,Ⅲ型退变21个。142个受累终板中,腰1~骶1均有累及。 结论 MRI在腰椎间盘退变合并腰椎终板骨软骨炎诊断中具有显示清晰,易分型的优点,对临床治疗方案的制订有重要的指导作用。

    [关键词] 腰椎间盘退变;腰椎终板骨软骨炎;MRI;分析

    [中图分类号] R445.2 [文献标识码] A [文章编号] 1674-4721(2012)02(c)-0104-02

    Analysis on the manifestations of MRI for patients with lumbar disc degeneration combined with lumbar end-plate osteochondritis

    WANG Hui JIANG Biao ZHOU Hang

    Department of Magnetic Resonance Imaging, Heilongjiang Province Hospital of Harbin City in Heilongjiang Province, Harbin 150036, China

    [Abstract] Objective To investigate the manifestations of MRI for patients with lumbar disc degeneration combined with lumbar end-plate osteochondritis. Methods The MRI data of 87 cases of patients with lumbar disc degeneration combined with lumbar end-plate osteochondritis in our hospital from January 2009 to October 2011 were retrospectively analyzed, and the imaging features were summarized. Results One hundred and forty two pieces of endplate of the 87 cases were involved, only one endplate was involved in 7 cases, and two or more endplates were involved in 80 cases. With Modic typing, 46 pieces were type Ⅰ, 75 pieces were type Ⅱ, 21 pieces were type Ⅲ. One hundred and forty two pieces of the endplates were distributed in L1-S1. Conclusion The MRI is clear, and it is easy to be typing correctly, so it can play a important guiding role in the treatment on the patients with lumbar disc degeneration combined with lumbar end-plate osteochondritis.

    [Key words] Lumbar disc degeneration; Lumbar endplate osteochondritis; MRI; Analysis

    腰椎退行性变在临床上较为常见,其常伴发椎间盘退变与突出、腰椎及椎小关节骨质增生以及韧带肥厚[1]。而腰椎间盘退变合并腰椎终板骨软骨炎在以往临床工作中并未得到重视,近年来随着MRI技术的发展及应用,本病才逐渐为临床所重视,椎体终板骨软骨炎为无菌性炎症,可造成下腰部的疼痛[2],为了提高临床对本病的认识,为临床治疗提供正确及时的诊断支持,笔者将近年来收治的腰椎间盘退变合并腰椎终板骨软骨炎患者的影像学资料进行分析,报道如下:

    1 资料与方法

    1.1 一般资料

    2009年1月~2011年10月本院经MRI检查确诊为腰椎间盘退变合并腰椎终板骨软骨炎患者87例,其中,男33例,女54例;年龄28~69岁,平均42.35岁;87例患者均有腰髂部疼痛,伴有下肢麻木、放射性钝痛、可有间歇性跛行、活动受限。

    1.2 仪器与方法

    全部病例均使用美国GE公司MR-Signa EXCITE HD 3.0T 磁共振扫描仪,体部线圈,所有患者均进行矢状面T1WI及T2WI 扫描。轴位进行T2WI 扫描,部分患者根据其具体情况加矢状面抑脂T2WI 扫描。

    扫描参数:矢状位T1WI ......

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