腰椎小关节MRI异常征象在腰痛患者中的临床意义  

Clinical significance of lumbar facet joint MRI findings in low back pain patients

作　　者：黄靖[1] 李曼[1] 袁慧书[1] 李选[1] 

机构地区：[1]北京大学第三医院放射科,北京100083

出　　处：《实用放射学杂志》2013年第12期1997-2000,2024,共5页Journal of Practical Radiology

摘　　要：目的分析腰痛患者腰椎小关节MRI影像学异常征象特点，初步探讨其临床意义。方法收集因腰痛于本科行腰椎MRI检查的216例患者为病例组，无腰痛主诉的91例正常志愿者为对照组。在腰椎MRI上分别对2组关节突关节骨关节炎分级、关节突关节积液征象进行评价，分析其与腰痛的关系。结果病例组L3～L4节段关节突关节1～4级的个数分别是2、310、105、15个，L4～L5节段关节突关节1～4级的个数分别是2、315、96、19个，L5～S1节段关节突关节1～4级的个数分别是2、311、100、19个，对照组L3～L4节段关节突关节1～4级的个数分别是136、40、60、0个，L4～L5节段关节突关节1～4级的个数分别是125、40、16、1个，L5～S1节段关节突关节1～4级的个数分别是119、54、9、0个，2组间分级的分布具有统计学差异（P〈0．01）。病例组L3～L4、L4～L5、L5～S1节段左侧、右侧小关节腰椎关节突关节积液（BFS）征的发生率分别是60．2％，57．4％；64．8％，64．4％；64．4％，55．1％。对照组L3～L4、L4～L5、L5～S1节段左侧、右侧小关节BFS征的发生率分别是15．4％，18．7％；16．5％，12．1％；11．0％，6．6％。2组间BFS征的发生率具有显著差异（P〈0．01）。结论椎小关节BFS征、椎小关节骨关节炎是发生腰痛的危险因素。Objective To analyze lumbar facet joint MRI findings in low back pain patients, and investigate its clinical significance. Methods 216 patients whose main cause of ＂low back pain＂ in our hospital were examined by lumbar spine MRI scan , 91 cases without low back pain were selected as control group. Abnormal lumbar MRI signs in two groups were respectively evaluated , including facet joint osteoarthritis grade, facet joint effusion, which relationship with low back pain was analyzed. Results In case group, the number of 1- 4 level facet joint in 1.3- 4 segment were 2,310,105,15, in L4- 5 segment were 2,315,96,19, and in L5- S1 segment were 2,311,100,19, respectively. In the control group, the number of 1- 4 level facet joint in L3-L4 segment were 136,40,60,0, in L4-L5 segment 125,40,16,1 and in L5-S1 segment 119,54,9,0, respectively（P〈0.01）. In case group, the incidence of bright facet sign（BFS） on the left and right facet joint of L3-4 segment, L4-5 segment, and L5-S1 segment were 60.2%, 57.4%; 64.8%, 64.4 %; 64.4%, 55.1%, respectively. In control group, the incidence of BFSon the left and right facet joint of L3--4 segment, L4-5 segment,and L5-S1 segment were 15.4%, 18.7%; 16.5%, 12.1% ; 11.0%, 6.6%, respectively （P〈0.01）. Conelusion The BFS signs of the facet joint, facet joint osteoarthritis are the risk factors of low back pain.

关 键 词：腰痛 腰椎退行性变 磁共振成像 

分 类 号：R681.57[医药卫生—骨科学] R445.2[医药卫生—外科学]