非强化表观弥散系数值对急性脑梗死预后的研究

目的研究非强化表观弥散系数（ADC）值对急性脑梗死预后的诊断价值。方法筛选33例经MR证实的突发急性脑梗死患者作为研究对像。发病6～12小时及间隔4天分别行MR检查,然后在DWI上计算出梗死灶的大小。根据梗死灶的大小有无扩大,将患者分为两组：梗死灶扩大组（组I,n=22）与无扩大组（组II,n=11）。随后在两组患者的ADC图上分别取3个点：梗死灶中心、半暗带和对侧相应部位正常脑实质,将测得病灶大小及ADC值进行统计学分析。结果发病6～12小时与间隔4天,DWI上病灶大小有显著统计学差异（P〈0.001）,梗死灶中心与半暗带ADC均值无统计学差异（P〉0.05）,两组半暗带ADC均值有显著统计学差异（P〈0.001）。结论梗死灶中心及半暗带的非强化ADC值对急性脑梗死预后评估及制定临床治疗方案是有帮助的。     

椎弓峡部裂在腰腿疼痛患者中的患病率及其与椎体滑脱的相关性

目的研究椎弓峡部裂在腰腿疼痛患者中的实际患病率,并探讨其与椎体滑脱的相关性。资料与方法筛选行MSCT扫描的5301例腰腿疼痛病例作为研究对象,详细记录有无椎弓峡部裂及椎体滑脱。结果 5301例中,发现椎弓峡部裂221例,其中男112例,女109例,男、女之间差异有统计学意义(χ2=220,P<0.001);在221例中有236个腰椎有椎弓峡部裂,其中单侧22个(9.95%),双侧214个。按照Meyerding分级,椎体Ⅰ度滑脱116个,Ⅱ度滑脱4个,无Ⅲ、Ⅳ度滑脱。双侧、单侧椎弓峡部裂滑脱发生率分别为55.14%、9.09%,二者之间差异有统计学意义(χ2=19.621,P<0.001,rs=0.277)。结论椎弓峡部裂在腰腿疼痛患者中的实际发生率约是4.17%(男性4.61%,女性3.80%),椎弓峡部裂与椎体滑脱呈低度相关。     

T2WI信号强度对确定腰椎间盘髓核退变的价值

目的研究腰搬间盘髓核T2信号强度与患者年龄、性别及与髓核退变程度的关系。方法回顾性分析422例腰椎间盘退行性变患者的MRI资料,征正中矢状位上测量髓核T2WI信号强度值．对不同级别的信号值进行非参数相关分析和t检验;对午龄与椎间盘信号值砭退变级别采用卡方检验和相关分析;对不同椎间盘水平的信号值进行t检验;对不同椎间盘水平间信号值进行非参数Spearman相关性分析。结果不同性别在同一级别和同一椎间盘水平的信号值差异均有统计学意义;年龄越大髓核信号值越低,髓核退变程度越高。T2WI信号强度可以代表椎间盘髓核退变程度。在所有腰椎间盘中第4～5腰椎间盘退变发生率最高结论腰椎间盘髓核T2信号强度与髓核退变程度及患者年龄具有相关性。T1信号强度有可能戍为一种评价髓核退变简便、易行的方法。     

腰椎间盘髓核退变的MRI研究(英文)

Objective The purpose of this study was to correlate T2 signal intensity values in nucleus pulposus of lumbar discs with patient age,gender and stage of nucleus pulposus degeneration.Methods Lumbar imaging findings of 422 cases subjects were retrospectively reviewed through T2 signal intensity values of nucleus pulposus evaluated based on the signal intensity values of MR T2-weighted mid-sagittal images of the lumbar spine,the t2 signal intensity values at all five lumbar levels (from L5-S1 to L1-L2) between male and female were used independent sample t-test and the Spearman correlation analysis.The age and grade of nucleus pulposus of disc degeneration and T2 signal intensity values were estimated by calculating and Chi-square test and the Spearman correlation analysis.The t-test was used to correlate the different anatomic levels of disc degeneration;T2 signal intensity values among the five different anatomic levels using non-parametric correlation analysis.Results There were significantly differences in T2 signal intensity values of nucleus pulposus at the same grade and anatomic level between male and female.Advanced with age,T2 signal intensity values of nucleus pulposus decreased and stage of disc degeneration increased accordingly.T2 signal intensity values may represent the nucleus pulposus degeneration of interverterbral disc.L4-L5 was the highest incidence among the nucleus pulposus degeneration of intervertebral disc.Conclusions The T2 signal intensity values based approach may be a feasible and practical tool to determine nucleus pulposus degeneration.T2 signal intensity values of nucleus pulposus of lumbar intervertebral disc are correlated with grade of degeneration and patient age.     

腰椎许莫氏结节与其易患因素的相关性研究

目的腰椎许莫氏结节(SN)与其易患因素的相关性研究。方法回顾性分析596例行腰椎MRI检查的患者T2WI矢状位的资料并统计SN个数。结果在研究样本中(男350例,女246例;平均年龄50.02岁),SN患病率8.08%(n=130,男77例;女53例,平均年龄53.78岁),其中,L1/2,L2/3最易患SN(19.45%)。多因素Logistic回归分析说明了男性、身高较高和体重较大者易患SN(P<0.005);但是,SN与年龄之间没有相关性(P>0.05)。结论男性、身高较高和体重较大者易患SN。     

腰椎间盘退行性变研究进展

目前,腰痛有很高的发病率[1],椎间盘退行性变可能是发生慢性腰痛的主要原因之一[2-3].根据组织学和MR检查,我们发现早在20岁时,椎间盘就已经有了退行性变[4-5].最早发生在髓核(nucleus pulposus,NP),以现有细胞的丢失和基质的改变为主.随着病变的进展,纤维环(annulus fibrosus,AF)的外层会改变其正常的层状排列顺序,从而使椎间盘的受力发生改变.久而久之,从AF内部向外部逐渐开始出现裂隙慢慢变为裂口,进而导致了整体性力学改变[6].这些变化增加了传递到椎体终板的力,引起微小的骨折和边缘骨赘形成.产生并刺激血管和神经向椎间盘内部生长的细胞因子在腰痛中也起了重要的作用[7].椎间盘退行性变的程度与腰痛的临床表现之间并没有很大的关系[8].