特发性脊柱侧凸两侧椎旁肌的影像学差异及其临床意义  

Radiological comparison of bilateral paravertebral muscles in adolescent idiopathic scoliosis and its potential importance

作　　者：邱勇[1] 吴亮[1] 王斌[1] 俞扬[1] 朱泽章[1] 钱邦平[1] 马薇薇[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,210008

出　　处：《中华骨科杂志》2006年第4期228-231,共4页Chinese Journal of Orthopaedics

摘　　要：目的研究特发性脊柱侧凸两侧椎旁肌的影像学变化,并探讨其与特发性脊柱侧凸病因的关系。方法共分三组:特发性脊柱侧凸组39例,男6例,女33例,平均年龄(14.0±1.1)岁。Cobb角40°～108°,平均55.8°±16.7°。KingⅡ型20例,KingⅢ型19例,顶椎位于T6￣T11。其中Cobb角>50°者18例,Cobb角≤50°者21例。先天性脊柱侧凸组25例,男12例,女13例,平均年龄(13.6±1.6)岁。Cobb角40°～155°,平均78.9°±32.1°,顶椎位于T5～T12。12例非脊柱侧凸病例作为对照组,男4例,女8例,平均年龄(23.2±5.8)岁。脊柱侧凸病例取顶椎区水平位MR像,对照组取上位腰椎非病变区水平位MR像,测量两侧椎旁肌的面积和Balance序列平均信号值。结果特发性脊柱侧凸和先天性脊柱侧凸组顶椎区凹侧椎旁肌平均横截面积明显小于凸侧(P<0.05),MRIBalance序列平均信号值明显高于凸侧(P<0.05)。对照组两侧差异无统计学意义(P>0.05)。特发性脊柱侧凸组中Cobb角>50°的病例顶椎区凹凸侧椎旁肌平均横截面积比值和平均信号比值与Cobb角≤50°的病例相比,差异无统计学意义(P>0.05)。结论特发性脊柱侧凸患者两侧椎旁肌存在影像学差异,这种差异可能系脊柱侧凸的继发性改变,且对判断脊柱侧凸的进展性具有潜在的临床意义。Objective To study the radiological change of bilateral paravertebral muscles in adolescent idiopathic scoliosis （AIS） and analyze its potential importance. Methods AIS group had 39 cases with average age of （14.0±1.1） years and average Cobb angle of 55.8°±16.7°（range, 40°-108°）, including 18 cases with Cobb angle〉50° and 21 cases with Cobb angle ≤50°. The apical vertebrae were from T6 to T11. Congenital scoliosis（CS） group covered 25 cases with average age of （13.6±1.6） years and average Cobb angle of 78.9°±32.1°（range, 40°-155°）. The apical vertebrae were from T5 to T12. Control group had 12 patients without scoliosis, 4 males and 8 females, with an average age of （23.2±5.8） years. The cross sectional area and signal intensity of paravertebral muscles in apical vertebral region on Balance sequences in AIS and CS groups and in non-diseased region in control group were analyzed on MRI. Results The cross sectional area of the paravertebral muscles on convex side was larger than that on concave side, but the signal intensity on Balance sequences of the paravertebral muscles on convex side was lower than that on concave side in AIS and CS groups （P〈 0.05 ）. But there was no statistical significant difference in control group in terms of the cross sectional area and the signal intensity（P 〉0.05）. In AIS group, the ratio of cross sectional area and signal intensity on Balance sequences of paravertebral muscle on concave side compared with convex side were 0.90±0.15 and 1.12±0.12 respectively in cases with Cobb angle〉50°, 0.87±0.13 and 1.09±0.09 respectively in cases with Cobb angle≤50°. No statistical significant difference was found between them（P 〉0.05）. Conclusion There exist radiological changes in paravertebral muscles in AIS, which may be secondary to AIS and have potential clinical importance on the evaluation of curve progression.

关 键 词：脊柱侧凸 放射学 病例对照研究 

分 类 号：R682[医药卫生—骨科学]