地方性氟骨症的脊柱MRI表现  

MRI of the spine in endemic fluorosis

作　　者：张永利[1] 王琦[1] 郭亚茹[1] 欧阳雪晖[1] 肖来柱[1] 多继诚 

机构地区：[1]内蒙古自治区医院介入放射科,呼和浩特010017 [2]内蒙古自治区地方病防治研究所氟骨病科

出　　处：《中华放射学杂志》2004年第10期1051-1055,共5页Chinese Journal of Radiology

摘　　要：目的　评价MRI在地方性氟骨症脊柱病变诊断中的作用。方法　对 81例地方性氟骨症的脊柱MRI进行分析和与X线比较。结果　所有椎体内脂肪含量减少和分布不均 ,在T1WI上信号强度表现为均匀或不均匀性减低 ,其信号减低程度与X线骨密度的增高程度相比较无明确相关性。 32例C3～ 7椎体的T1WI信号强度平均值明显低于 10 0例对照组 (P <0 0 0 1)。 81例中后纵韧带和黄韧带骨化 71例 (88% ) ,其中后纵韧带骨化 35例 (4 3% ) ,黄韧带骨化 8例 (10 % ) ,后纵韧带和黄韧带骨化 2 8例 (35 % ) ,与X平片所显示的相同。在T1WI上 6 3例后纵韧带骨化和 36例黄韧带骨化有中等信号强度区者分别为 32例 (5 1% )和 31例 (86 % )。 81例中椎间盘突出 6 8例 (84 % ) ,椎间盘变性 5 7例 (70 % ) ,椎管狭窄 75例 (92 % ) ,脊髓受压 6 3例 (78% ) ,其中脊髓内有病理学改变 2 8例 (35 % )。X线测量 5 7例颈椎椎管前后径 <9mm(以此推断脊髓受压 ) 4 1例 (71 92 % ) ,MRI显示脊髓受压 4 8例(84 2 1% ,P =0 115 )。 5 7例颈椎椎间盘后突出 5 1例 (89 4 7% ) ,明显高于对照组 (6 2 % ) (P <0 0 0 1) ;椎间盘变性 37例 (6 4 91% ) ,与对照组 (37% )相比较差异有非常显著性意义 (P =0 0 0 1)。结论　MRI显示地方性氟骨症的椎体信号?Objective To evaluate role of MRI in the diagnosis of the spinal lesions in endemic fluorosis.Methods MRI of the spine in 81 patients with endemic fluorosis, including the cervical spine in 57 patients, thoracic spine in 10, and lumbar spine in 14, were analyzed and compared with X-ray plain films.Results Fat-containing marrow in the vertebral bodies with endemic fluorosis was decreased and unevenly distributed. Signal intensity of the vertebral bodies was homogeneously or inhomogeneously decreased on T 1- and T 2- weighted images. The mean values of signal intensity of the cervical vertebral bodies from 3rd to 7th were lower in 32 patients with fluorosis than those in 100 patients of the control group on T 1-weighted image (P<0.001), and the decreased signal intensity was not interrelated to the increase of the bone density on X-ray plain films. Of the 81 patients with endemic fluorosis, MRI showed ossification of the posterior longitudinal ligament (OPLL) and yellow ligament (OYL) in 71 patients (88%), including OPLL in 35 patients (43%), OYL in 8 (10%), and both in 28 (35%), which was same as on X-ray plain films. On T 1-weighted images, the signal intensity similar to yellow bone marrow within OPLL in 63 patients and within OYL in 36 patients was observed in 32 patients (50%) and in 31 patients (86%), respectively. Of the 81 patients, herniation of the intervertebral disk was found in 68 patients (84%), degeneration of the intervertebral disk was observed in 57 patients (70%), and spinal canal narrowing was found in 75 patients (93%), in which compression of the spinal cord was showed in 63 patients (78%) and pathologic changes within the cord were noted in 28 patients (35%). In 57 patients with fluorosis, MR showed compression of the cervical spinal cord in 48 patients (84.21%), the anterioposterior diameter of the cervical spinal canal on X-ray plain film was either 9 mm or less at any level of the vertebra (indicating the compression of the cervical spinal cord) in 41 (71.92%) patients (P=0.115). In

关 键 词：地方性氟骨症 脊髓受压 黄韧带骨化 MRI 椎体 髓内 对照组 显示 信号强度 不均匀性 

分 类 号：R445.2[医药卫生—影像医学与核医学]