腰椎后缘软骨结节的MRI研究  

MRI Study of Lumbar Posterior Marginal Cartilaginous Node

作　　者：詹阿来[1] 

机构地区：[1]福建省漳州市医院放射科,363000

出　　处：《临床放射学杂志》2000年第3期162-164,共3页Journal of Clinical Radiology

摘　　要：目的　分析腰椎后缘软骨结节的MRI表现并总结其病理解剖特征。材料与方法　回顾性分析 16例典型病例的MRI表现 ,对比各种扫描序列在显示病变特征上的差异。采用GEVectraⅡ 0 .5T超导型MR机 ,常规行矢状面扫描 ,病变局部横断面GRET2 WI扫描。 5例用GRE序列加作矢状面局部放大扫描。结果　MRI主要表现为病变椎体后上缘或后下缘终板局限性浅弧形凹陷 ,凹陷区内充满椎间盘组织 ,凹陷终板的后缘均超出相邻椎体后缘连线 ,椎间盘后纤维环明显后凸 ,硬膜囊前缘受压。GRET2 WI对上述征象的显示较其他序列清楚 ,可明确显示凹陷的终板有不规则增厚 ,与CT上软骨结节周围骨质硬化相吻合 ;椎间盘后纤维环呈明显低信号 ,3例可见明显断裂。SET1WI在凹陷的终板下方可见带状高信号影。横断面GRET2 WI所见与CT基本相似。 16例中 4例合并髓核脱出。结论　腰椎后缘软骨结节的MRI表现具有特征性 ,GRET2 WI在显示其特征上优于其他序列 ;“腰椎后缘软骨结节”或“腰椎软骨板破裂症”均未能概括该病的主要特征 ,但目前尚无更恰当的命名。Objective To analyze the MRI manifestation of lumbar posterior marginal cartilaginous node (LPMCN) and to summarize its pathoanatomical features.Materials and Methods MRI findings of 16 typical LPMCN cases were retrospectively analyzed. A comparison of the demonstration of the lesion morphology was made between different pulse sequences, as well as between MRI and CT. Sagittal T 1WI, T 2WI or T 2 *WI of lumbar spine were obtained with SE, FSE or GRE pulse sequence on a 0.5T superconducting MR scanner. Magnified scan of involved lumbar vertebrae with GRE pulse sequence was performed in 5 cases.Results The main MRI finding was a circumscribed hollow in the involved end plate, which was filled with disc tissue. The posterior margin of involved end plate exceeded normal vertebral margin. The posterior fibrous anulus (Sharpey's fibers) of disc protruded posteriorly, pressing the sac. GRE T 2 *WI was superior to other pulse sequences in demonstrating the above changes. Rupture of the posterior part of the fibrous anulus was seen in 3 cases, and herniation of nucleus pulposus in 4 cases.Conclusion LPMCN has some characteristic signs on MRI, and GRE T 2 *WI is the best pulse sequence for demonstrating these signs. The terms, “lumbar posterior marginal cartilaginous node” and “lumbar vertebral end plate rupture” being generally used by radiologists and surgeons, don't summarize the main features of LPMCN, but, unfortunately, there is no an appropriate term up now.

关 键 词：腰椎终板 软骨结节 椎间盘位 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]