腰椎Modic改变影像学比较研究  

A comparative study of radiographic lumbar Modic changes

作　　者：许凤[1] 邹月芬[2] 徐磊[2] 冯阳[2] 赵盛[1] 

机构地区：[1]盐城卫生职业技术学院医学影像学院,江苏盐城224001 [2]南京医科大学第一附属医院放射科

出　　处：《实用放射学杂志》2015年第9期1493-1495,1502,共4页Journal of Practical Radiology

摘　　要：目的：分析 Modic 改变（MC）的X线、CT 及 MR 影像表现及其意义。方法回顾性分析因腰腿痛就诊患者的腰椎影像学资料（MR、CT、X线）,由2位肌骨方向的影像诊断医师双盲分析,均使用同一台处理器。先依据 MRI 进行 MC 分型,后判断 X线平片、CT 图像相应区域的密度变化情况,如果分型及判断结果有异议,另请1名影像诊断主任医师加入讨论,取一致结果。数据采用 Excel 2010录入,并使用 SPSS 16.0软件进行数据整理和统计学分析。结果共收集符合要求的病例47例,其中男16例,女31例,年龄32～76岁,中位年龄56.0岁。MRI 上共93个终板发生 MC,其中部分腰椎 MRI 上终板改变的区域,其 X 线平片、CT重建图像密度较正常椎体有增高（共36个）,其中Ⅰ型、Ⅱ型、Ⅰ/Ⅱ型的发生率分别为40.0%、14.8%、58.3%,而Ⅲ型及含有Ⅲ型的混合型发生率100%。结论部分 ModicⅠ型、Ⅱ型、Ⅰ/Ⅱ型改变在 X 线平片、CT 重建图像有密度增高影,推测该区域有反应性新生骨生成,其反映了椎体内部骨的矿物化而非骨髓的变化。Objective To analyze the imaging performances and significance of Modic changes on X-ray,CT and MRI.Methods The imaging data （MR,CT and X-ray）of patients with low back pain were retrospectively analyzed.The selected patients’images were studied on the same work station by the two physician experts in muscle and bone imaging.A double-blind method was used. Firstly,MRI was used to sort the MC.Then,the alterations of the density in the lesions on X-ray plain film and CT image were measured.if the judgments of the two readers were inconsistent,another professor of radiology will join the discussion and consistent results will be got finally.The data were recorded using Excel 2010,and processed for statistical analysis using SPSS 1 6.0.Results A total of 47 cases that met the requirements were collected which included 1 6 males and 31 females,aged from 32 to 76 years,with a median age of 56.0 years.A total of 93 on MRI endplate were changed.However,a part of lumbar endplates with MC on MRI images were displayed as higher density than normal vertebral body on the X-ray and CT reconstruction images （total of 36）.The occurrence rates of Type Ⅰ,Type Ⅱ,Type Ⅰ/Ⅱ were 40.0%,14.8%,58.3%,respectively.But the occurrence rate of Type Ⅲ （100%）and hybrid Type which contained type Ⅲ were 100%.Conclusion Some Modic typeⅠ,Ⅱ,Ⅰ/Ⅱchanges in X-ray plain film, CT reconstruction images had a higher density,speculating that there is reactive new bone formation,which reflects the internal vertebral body bone mineralized rather than the change of the bone marrow.

关 键 词：腰椎 MODIC改变 X线摄影术 计算机体层成像 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R814.42[医药卫生—外科学]