MRI对腰椎Modic各型改变终板硬化诊断能力的研究  

Study on the capability of MRI for detecting endplate sclerosis in different modic types of lumbar spines

作　　者：朱建忠[1] 刘军杰[2] 秦健[2] 程玉卉[1] 辛越[1] 

机构地区：[1]泰山医学院附属医院影像中心,山东泰安271000 [2]泰山医学院

出　　处：《实用医学影像杂志》2010年第4期247-249,共3页Journal of Practical Medical Imaging

摘　　要：目的评价腰椎不同类型Modic改变中是否存在终板硬化和MRI诊断终板硬化的能力。方法回顾性分析68例患者脊椎腰段(L3～S1)的影像学资料,阅片分析MRI图像Modic改变和CT片的终板硬化;记录ModicⅠ和Ⅱ型中T1、T2信号强度及CT的HU值。结果共发现35例患者MRI显示有78个终板发生Modic改变,Ⅰ型13%,Ⅰ/Ⅱ混合型12%,Ⅱ型66%,Ⅱ/Ⅲ混合型8%,Ⅲ型1%;36%的终板Modic改变CT显示存在硬化,尤其是Ⅰ/Ⅱ和Ⅱ/Ⅲ混合型;MRI图像定量分析未表现终板硬化。结论终板硬化不仅存在于ModicⅢ型改变,并可存在所有类型,尤其是混合型;MRI不能表现终板硬化,可能取决于骨髓矿物质含量。Objective To evaluate the presence of endplate sclerosis in different types of Modic changes and to assess the capability of MRI in detecting endplate sclerosis within these changes.Methods The lumbar spines（L3-S1） of 68 patients were retrospectively reviewed to determine Modic changes and disc degeneration from MRI and endplate sclerosis from CT.MRI T1-and T2-weighted signal intensity and CT HU measurements of type Ⅰ and Ⅱ Modic changes were recorded.Results Altogether 68 Modic changes in 35 subjects were recorded：13% were type I,12% mixed type Ⅰ/Ⅱ,66% type Ⅱ,8% mixed type Ⅱ/Ⅲ,and 1% type Ⅲ.Thirty-six of the endplates with Modic changes had sclerosis on CT images,especially in mixed Ⅰ/Ⅱ and Ⅱ/Ⅲ Modic types.Endplate sclerosis was not detected in MRI in a quantitative analysis.Conclusions Endplate sclerosis exists in all types of Modic changes,especially in mixed Modic types,and not only in type III changes.Endplate sclerosis was not detected in MRI,which may depend on the amount of mineralization of the bone marrow.

关 键 词：终板硬化 MODIC改变 腰椎 磁共振 体层摄影术 X线计算机 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.57[医药卫生—诊断学]