腰椎间盘突出症髓核的病理学变化与MRI的相关性  

Correlation between MRI and pathological changes of nucleus pulposus in patients with lubar intervertebral disc protrusion

作　　者：范志海[1] 金志高[1] 吕海军[2] 沈忆新[1] 

机构地区：[1]苏州大学附属第二医院骨科,江苏省215004 [2]苏州大学附属第二医院病理科,江苏省215004

出　　处：《江苏医药》2013年第8期917-919,F0003,共4页Jiangsu Medical Journal

基　　金：国家自然科学基金(81271723);苏州大学附属第二医院青年职工预研基金(SDFEYQN1104)

摘　　要：目的探讨腰椎间盘突出症患者髓核的病理学变化及与MRI表现之间的相关性。方法随机选取100例腰椎间盘突出症患者,计算相对表观弥散系数(ADC)值。对髓核组织进行HE及甲苯胺蓝染色,并分析MRI相对强度与病理学变化的关系。结果 MRI信号检测到Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ级的椎间盘分别为0、38、46、13和3个,其中的Ⅱ、Ⅲ、Ⅳ-Ⅴ级分别对应病理学变化轻、中、重度。MRI相对ADC值越低,髓核退变程度越严重;且MRI相对强度与病理学变化呈正相关(r=0.4823,P<0.05)。结论 MRI髓核信号强度等级与椎间盘髓核细胞的病理学变化密切相关,可以为评估临床疗效及判断预后提供依据。Objective To investigate the pathological changes of nucleus pulposus in patients with lubar intervertebral disc protrusion and the correlation between MRI and those changes. Methods A total of 100 patients with lubar intervertebral disc protrusion was collected, and the value of relative apparent diffusion coefficient（ADC） was calculated. Nucleus pulposus tissues were taken and stained by HE and toluidine blue dyes. The correlation between relative intensity of MRI and pathological changes was analyzed. Results MRI signal intensity of Ⅰ , Ⅱ , Ⅲ, Ⅳ and Ⅴ was detected in 0,38,46, 13 and 3 cases, respectively, of which Ⅱ , Ⅲ and Ⅳ-Ⅴ grades corresponded with the specific light, middle and serious pathological changes. The lower the relative ADC value, the more serious the degeneration of nucleus pulposus. The relative intensity of MRI was positively correlated with pathological changes （r=0. 4823, P〈0. 05）. Conclusion The relative signal intensity of MRI is closely related to pathological changes of nucleus pulposus cells in intervertebral disc protrusion, which provides a potential basis for evaluating the therapeutic efficacy and predicting the prognosis.

关 键 词：椎间盘突出 髓核 核磁共振成像 

分 类 号：R681[医药卫生—骨科学]