腰椎间盘前缘与后缘高信号区的临床对照研究

目的 通过与腰椎间盘后缘高信号区(HIZ)比较,探讨前缘HIZ的发生规律、分布及临床意义.方法 根据HIZ的诊断及定位,将610例有完整临床资料的腰椎MRI,依据有无HE及其发生部位分为对照组(无HIZ),前缘组,后缘组和前后缘组.统计总样本中HIZ发生率,对比分析各组性别比例、年龄、体重、腰痛发生率及HIZ分布规律.结果 610例患者中,对照组315例(51.6%),前缘组95例(15.6%,119个椎间盘),后缘组159例(26.1%,189个椎间盘),前后缘组41例(6.7%,96个椎间盘).前、后缘组发生率间存在显著的统计学差异(P<0.01).各组的性别构成和体重载明显差异(P>0.05),年龄间存在显著的统计学差异(P<0.01,对照组<后缘组<前后缘组<前缘组).前缘组多见于L1,2～L4,5,后缘多位于L3,4～L5S1对照组、前缘组、后缘组和前后缘组腰痛发生率分别为40.0%,52.6%,55.4%和65.8%,对照组明显低于其他三组(P<0.05),后三组间差异无统计学意义(P>0.05).结论 与纤维环后缘HIZ相比,前缘HIZ发生率较低,患者年龄较大,发生节段较高,与腰痛症状亦明显相关.

Clinical investigation of high-intensity zone in anterior annulus fibrosus of lumbar disc: compared with high-intensity zone in posterior annulus fibrosus

Objective To explore the prevalence, distribution and clinical significance of high-intensity zone (HIZ) in anterior annulus fibrosus (AF) in comparison with HIZ in posterior AF of lumbar disc. Methods According to the diagnosis and location of HIZ, 610 lumbar magnetic resonance images with entire clinical materials were divided into control group (without HIZ), anterior AF group (HIZ), posterior AF group (HIZ) and anterior & posterior (AP) AF group (HIZ). The incidence of HIZ was summarized. The clinical data, such as male/female ratio, age, and body weight, prevalence of low back pain (LBP) and distribution of HIZ, were compared and analyzed between the groups. Results Three hundred and fifteen cases shown no HIZ (51.6%), 95 cases presented HIZ in anterior AF (15.6%, 119 discs), 159 cases presented HIZ in posterior AF (26. 1%, 189 discs) and 41 cases presented HIZs in both anterior and posterior AF (6. 7%, 96 discs). There was significant difference between the prevalence of HIZ in anterior AF and that in posterior AF (P<0.01). The male/female ratio and body weight of each groups showed no difference (P>0.05),and the age was proved to be statistically different between four groups (P<0.01,control group < posterior AF group < AP AF group < anterior AF group). HIZs in anterior AF often occurred at L1,2～L4,5, whereas, they usually developed at L3,4～L5S1 in posterior AF. The incidence of LBP in control group, anterior AF group, posterior AF group, AP AF group were 40. 0%, 52. 6%, 55.4% and 65. 8%, respectively. The LBP prevalence of control group was lower than that of other three groups (P<0. 05) ,and the prevalence of last three groups showed no difference(P>0.05). Conclusions Compared with HIZ in posterior AF, the HIZ in anterior AF of lumbar disc has a lower prevalence, often develops in elder patients and in upper motion segments. It also indicates an obvious relation to LBP as the former.