腰椎峡部裂的MRI评价  

Evaluation of MRI in lumbar spondylolysis

作　　者：肖德贵[1] 李振芝[1] 王振福[1] 王黎明[1] 王晓华[1] 吴伟[1] 

机构地区：[1]山东省威海市立医院影像科,山东威海264200

出　　处：《医学影像学杂志》2003年第4期267-270,共4页Journal of Medical Imaging

摘　　要：目的 :描述腰椎峡部裂的MRI表现 ,探讨MRI在本病中的诊断价值。方法 :回顾性分析经X线平片或CT证实的 2 9例腰椎峡部裂患者 (单纯崩裂 5例、崩裂滑脱 2 4例 )及 2 5例退行性腰椎滑脱患者的MRI检查资料 ,并对崩裂滑脱与退行性滑脱的MRI表现进行对比分析。结果 :2 9例峡部裂患者双侧椎弓峡部均出现不规则状T1WI低信号、T2 WI低或高信号骨性缺损。单纯崩裂组椎管前后径 19.0mm± 2 .7mm ,不伴有脊柱滑脱、椎间盘假性膨出及椎间孔变形 ;3例患椎棘突基底部与硬膜囊之间存在脂肪间隙 ;所有患椎棘突基底部均位于上下棘突基底部连线前方。崩裂滑脱组椎管前后径2 5 4mm± 4 .4mm ,均伴有脊柱滑脱、椎间盘假性膨出、椎间孔变形 ;患椎棘突基底部与硬膜囊之间均存在脂肪间隙 ;患椎棘突基底部位于上下棘突基底部连线后方 2 3例 ,稍前方 1例。退行性滑脱组椎弓峡部完整 ,无骨性缺损 ;椎管前后径15 2mm± 1.6mm ,明显小于崩裂滑脱组 (t =10 .87,P <0 .0 1) ,2 5例均伴有椎间盘假性膨出及椎间孔变形 ;患椎棘突基底部与硬膜囊之间无脂肪间隙 2 4例 ,存在线状脂肪间隙 1例 ;患椎棘突基底部均位于上下棘突基底部连线前方。结论 :腰椎峡部裂有特征性MRI表现 ,MRI可为临床评价该病提供正确。Objective:To describe the MRI manifestations of lumbar spondylolysis and evaluate the diagnostic value of MRI in this disease.Methods:The MR images in 5 cases of simple spondylolysis, 24 cases of spondylolytic spondylolisthesis and 25 cases of degenerative spondylolisthesis (confirmed by conventional radiography or CT) were retrospectively analyzed.Results:Irregular bony defects which were hypointense on T 1WI and hypointense or hyperintense on T 2WI in the interarticular part were found in all of 29 cases of lumbar spondylolysis.In simple spondylolysis group,the anterior posterior diameter of the canal was 19.0mm±2.7mm. No spondylolisthesis, pseudobulging disks and deformed neural foramens were found. Widened fat space between sac and basement of the spinous process were found in 3 cases. The basement of spinous process of the affected vertebrae was displaced forward to the joining line of the upper and lower basement of spinous process in all of 5 cases. In spondylolytic spondylolisthesis group,elongated anterior posterior diameter of the canal(25.4mm±4.4mm),spondylolisthesis,pseudobulging disks,deformed neural foramens,and widened fat space between sac and the basement of the spinous process were found in all of 24 cases. The basement of spinous process of the affected vertebrae was displaced back to the joining line of the upper and lower basement of spinous process in 23 cases. In degenerative spondylolisthesis group, no isthmus defects were found. The anterior posterior diameter of the canal(15.2mm±1.6mm) was significantly narrower than spondylolytic spondylolisthesis group(t=10.87, P<0.01). Pseudobulging disks(n=25),deformed neural foramens(n=25), and widened fat space between sac and the basement of the spinous process(n=1) were found in this group. The basement of spinous process of the affected vertebrae was displaced forward to the joining line of the upper and lower basement of spinous process in 25 cases.Conclusion:There are characteristic MRI features of the lumbar spondylolysis. MRI provide

关 键 词：腰椎峡部裂 MRI 评价 诊断 

分 类 号：R681.5[医药卫生—骨科学]