更年期慢性下腰痛女性椎体骨密度与Modic改变的相关性  

Correlation of Vertebral Bone Mineral Density and Modic Changes in Menopausal Females with Chronic Low Back Pain

作　　者：谷学智 陈兴灿[1] 刘淼[2] 何东[2] 赵才勇 王海涛[2] 

机构地区：[1]温州医科大学,浙江温州325035 [2]解放军第117医院放射科,浙江杭州310013

出　　处：《中国医学影像学杂志》2015年第7期536-538,543,共4页Chinese Journal of Medical Imaging

基　　金：2010年度南京军区医学科技创新课题项目(10MA128);浙江省医学会临床科研基金项目(2011ZYC-A43)

摘　　要：目的既往文献报道女性Modic改变的发生率高于男性,推测可能与更年期女性体内激素水平改变导致骨质疏松等因素有关。本文对更年期慢性下腰痛女性椎体骨密度与腰椎MRI上Modic改变的相关性进行研究,探讨椎体骨密度在Modic改变中的意义。资料与方法选择慢性下腰痛更年期女性205例,行椎体骨密度测定及腰椎MRI检查,测定椎体骨量并观察影像学资料。将所有患者根据其骨量水平分为骨量正常组(128例)、骨量减少组(58例)及骨质疏松组(19例)。比较3组Modic改变的发生率,分析椎体骨密度与Modic改变的关系。结果 205例患者中,骨量正常128例,Modic改变44例(I型19例,II型22例,III型3例),发生率为34.4%;骨量减少58例,Modic改变34例(I型15例,II型17例,III型2例),发生率为58.6%;骨质疏松19例,Modic改变15例(I型6例,II型7例,III型2例),发生率为78.9%。3组间Modic改变发生率差异有统计学意义(χ2=18.995,P<0.05)。Pearson列联系数C=0.29<0.40。骨量减少组、骨质疏松组Modic改变发生率均高于骨量正常组(χ2=9.636、13.680,P<0.01),骨量减少组与骨质疏松组间Modic改变发生率比较差异无统计学意义(χ2=2.555,P>0.05)。结论更年期慢性下腰痛女性椎体骨密度与Modic改变有相关性。Modic改变的发生率随着椎体骨密度的减低而升高,但其关联性较弱,Modic改变的发生是一个动态发展的过程,除椎体骨密度外还受其他因素的影响。Purpose It has been reported that women have higher incidence of Modic changes than men and it may be related to the change of female hormone levels during menopause which leads to osteoporosis and other factors. This paper investigated the relationship between vertebral bone mineral density（BMD） of menopausal female suffering from chronic low pain and lumbar vertebral Modic changes on MRI, to explore the effect of vertebral bone mineral density upon Modic changes. Materials and Methods A total of 205 menopausal women with chronic low back pain were enrolled and underwent vertebral bone mineral density measurement and lumbar MRI examination. The bone mass of vertebral body and bone imaging data were observed. All patients were divided into three groups according to their level of bone mass： group of normal bone mass： 128 cases; osteopenia group： 58 cases; osteoporosis group： 19 cases. The incidence rate of Modic changes was compared among the three groups and the relationship between bone mineral density and vertebral Modic changes was further analyzed. Results Among 205 patients, 128 were with normal bone mass, 44 had Modic changes（type I： 19 cases; type II： 22 cases; type III： 3 cases） and the incidence rate was 34.4%; osteopenia occurred in 58 patients, among whom 34 had Modic changes（type I： 15 cases; type II： 17 cases; type III： 2 cases）, which showed that the rate was 58.6%; 19 patients presented osteoporosis, 15 of whom appeared Modic changes（type I： 6 cases, type II： 7 cases; type III： 2 cases）, with the rate of 78.9%. There was statistically significant difference in incidence rate of Modic changes among the three groups（χ^2=18.995, P〈0.05）. Pearson column connection number C=0.290.40. The osteopenia group and osteoporosis group both had higher incidence rates than the group of normal bone mass（χ^2=9.636 and 13.680, P〈0.01）, and the incidence rate showed no difference between the osteopenia group and osteoporosis group（χ^2=2.555, P〈0.05）. Con

关 键 词：更年期 腰痛 腰椎 骨密度 磁共振成像 Modic退变 女(雌)性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.5[医药卫生—诊断学]