不同程度退变的软骨终板的影像学变化及其临床意义  

Imageology change of degenerative cartilage endplate to different degree and its clinical significance

作　　者：苗胜[1] 沙广钊 王永东[1] 颜连启[1] 宋良玉[1] 郭政[1] 范磊[1] 邵林[1] 

机构地区：[1]邳州市人民医院骨科,江苏邳州221300

出　　处：《中国骨伤》2008年第6期414-417,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:从影像学角度研究腰椎间盘不同程度退变时终板在矢状面和横断面的形态变化规律,探讨其临床意义。方法:本研究选取58例L4,5椎间盘呈退行性改变的影像学资料(MRI、CT)进行研究(其中椎间盘突出者34例),分别将其矢状位MRIT2WI成像采用MRI机内Mean/Curve测量软件测量L4,5运动节段退变的椎间盘与相应节段脑脊液平均信号强度比值,判断椎间盘退变程度进行分组。分为3组:轻度退变组17例,中度退变组17例,重度退变组24例。同时采用正中矢状位MRIT2WI成像分别测量相应椎间(L4,5)终板于矢状面上的凹陷角。另外借助L4,5椎间CT平扫成像测量其相邻终板的最大前后径和横径,计算终板的相对曲率,分析椎间盘在不同退变程度下椎体终板凹陷角及其相对曲率的变化规律,并探讨椎体终板的凹陷角与其相对曲率的相关性。结果:①椎体终板(L4下终板,L5上终板)凹陷角均随着相应椎间盘退变程度加重而增大,重度退变组与中度、轻度退变组(L4下终板、L5上终板)凹陷角差异均有统计学意义(P<0.01)。②重度退变组与轻度退变组(L4下终板、L5上终板)相对曲率差异有统计学意义(P<0.01),中度退变组与轻度退变组(L4下终板、L5上终板)相对曲率差异有统计学意义(P<0.01),中度退变组与重度退变组(L4下终板、L5上终板)相对曲率差异无统计学意义(P>0.05)。③终板凹陷角与其相对曲率呈正相关关系(r=0.786,0.490)。结论:椎体终板的凹陷角与相对曲率随着椎间盘退变程度加重而发生相应变化,这种变化是腰椎间盘退变突出、椎间盘源性下腰痛的重要因素,且椎体终板的凹陷角与其相对曲率存在着相关关系,故可以通过凹陷角的变化判断其相对曲率的改变,评估椎间盘突出的概率。Objective ：To study the imageology changes of degenerative cartilage endplate to different degree, and to explore its clinical significances, Methods ：The imageology data（MRI or CT） of 58 patients with degenerative disc disease of L4,5 （including 34 patients with lumbar disc hemlation ）. The patients were divided into three groups depending on the mean signal intensity rate of degenerative disc and cerebrospinal fluid：llght degenerative group of 17 cases,intermediate degenerative group of 17 cases ,and severe degenerative group of 24 cases. The signals of intervertebral disks on T2WI of saglttal magnetic resonance imaging were inputted into the computer and the concave angles of endplate were measured. Anteroposterior diameter and transverse diameter of the endplate were measured from the CT scan of L4,5, and then the relative curvature of endplate was got. The change patterns of the concave angle and the relative curvature of vertebral endplates were analyzed when the lumbar disc was differently degenerative, Results ： ①The concave angle of endplate （L4 inferior endplate, L5 superior endplate） gradually increased among the light degenerative group ,intermediate degenerative group and severe degenerative group （P〈 0,01 ）. ②The relative curature of endplate （L4 inferior endplate, L5 superior endplate ） gradually increased. There was significant difference between the light degenerative group and intermediate degenerative group （P〈0.01）, and there was significant difference between the light degenerative group and severe degenerative group （P〈0.01）. There were no significant difference between intermediate degenerative group and severe degenerative group （P〉0,05）. ③The concave angle of endplate had positive correlation with relative circularity （r=0.786,0.490）. Conclusion：The concave angle and relative curvature of endplate generate corresponding changes when the lumbar disc are differently degenerative. The changes of concave angle and relative curvature

关 键 词：腰椎 椎间盘 磁共振成像 摄影测量法 

分 类 号：R681.53[医药卫生—骨科学] R681.5[医药卫生—外科学]