脊柱许莫氏结节增强MRI表现  

The Characteristics of Spinal Schmorl's Nodes on Contrast Enhanced MRI

作　　者：王冰[1] 孔祥泉[1] 刘定西[1] 陈友三[1] 周敏[1] 吴文骏[1] 邓先波[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2015年第10期1633-1637,共5页Journal of Clinical Radiology

摘　　要：目的探讨脊柱许莫式结节(SN)的增强MRI表现特征。方法对282例SN患者的MRI平扫及增强扫描表现进行回顾性分析,统计SN的数目、位置分布、增强后表现特征、邻近骨髓信号改变及大小特点,分析上述相关因素与SN的相关性。结果 282例共发现602个SN,其中97例(34.4%)144个(23.9%)呈现不同程度的强化。强化SN多位于腰椎(68.8%),且好发于椎体终板的中后部1/3。强化SN与未强化SN在椎体上、下终板的分布差异有显著性统计学意义(χ2=6.09,P<0.05)。SN的强化表现形式有完全强化、环形强化和不均匀强化。邻近终板伴或不伴骨髓水肿的SN在增强扫描后是否强化有显著性意义(χ2=56.66,P<0.05),强化SN较未强化SN大(Z=-16.47,P<0.05),且在强化SN中,伴邻近骨髓水肿的SN较不伴骨髓水肿的SN大(Z=-3.18,P<0.05),腰痛者的SN较无腰痛者的SN大(Z=-4.61,P<0.05)。结论强化SN好发于腰椎,强化表现形式多样,且较未强化SN大,强化SN中伴骨髓水肿及腰痛者的SN较大,增强MRI对SN血管化的显示及SN的临床诊断、鉴别诊断具有重要价值。Objective To investigate the characteristics of spinal Schmorl＇s Nodes after MRI enhancement scanning.Methods We selected 282 patients who were diagnosed with Schmorl＇s Nodes by plain and contrast enhanced MRI scans,and then analyzed the features of SNs on number,distribution,the characteristic of enhanced SN,the signal of the adjacent marrow and the size retrospectively. Results Among 282 patients,97（ 33. 2%） cases presented 144 enhancing SNs.Most of the enhanced SN was located on L1～ L5 and they were often seen on the middle posterior part of the endplate.Differences were significant between the enhanced and nonenhanced SN which were prone to appear the upper or lower endplate（ P 〈0. 05）. The manifestation of enhanced SN contained complete enhancement,ring enhancement and heterogeneous enhancement. SNs with the marrow edema were easier to be enhanced（ χ2= 56. 66,P〈 0. 05）. The size of enhanced SNs was significantly bigger than the nonenhanced SN（ P〈 0. 05）. In the enhanced SNs,the size of SNs with the marrow edema was bigger than those not,the size of SNs in the patients with low back pain was larger than those without pain.Conclusion Enhanced SNs are prone to appear on the lumbar vertebra and have different manifestations. The size of enhanced SN is bigger than the nonenhanced one. Contrast enhanced MRI can show the vascularization of SN and provide important reference value for the clinical and differential diagnosis.

关 键 词：脊柱 许莫式结节 增强MRI 强化 

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]