MR对椎体终板骨软骨炎的诊断价值及临床意义

目的:研究椎体终板骨软骨炎的MR表现特征,评价对该病变的MRI诊断及探讨其分型、分期及与下腰痛的关系。方法:搜集85例经MRI检查确诊的腰椎椎体终板骨软骨炎的图像资料,对其MR表现进行回顾性分析,其中男55例,发病率约65%;女30例,发病率约35%。结果:本组所有椎体终板骨软骨炎病例,均可显示不同程度的椎间盘变性或膨(突)出表现,椎间盘及相邻椎体边缘出现斑片状、条片状异常信号灶,T1WI序列呈低信号或高信号,T2WI序列呈高信号或低信号,TIRM序列呈低信号或等信号。63例可见Schmorl结节突入椎体内呈纽扣样缺损。按照Modic等对椎间盘退行性病变有关软骨终板变性的分型标准,85例中,Ⅰ型病例6例,约占病变的7%;Ⅱ型病例70例,约占病变的83%;Ⅲ型病例9型,约占病变的11%。69%(59/85例)的终板软骨炎患者有下腰痛症状,其中骨髓型Modic1型、Schmorl结节伴周围Mod ic1型、椎间盘型患者下腰痛的发生率明显高于其他型,Modic1型终板经保守治疗后完全或部分转换为Modic2型,腰痛症状减轻或消失,而Modic2型病例经随访MRI表现及临床症状保持稳定。结论:腰椎终板软骨炎是椎间盘退变的一种表现,是造成局部下腰痛的原因之一,MRI是最佳检查手段。

MR of Vertebral Bone and Cartilage Endplate of Inflammation of Diagnostic Value and Clinical Significance

Objective:To study the vertebral end plate osteochondritis characteristic MR findings,the evaluation of the MRI diagnosis of disease and explore its type,stage,and the relationship with low back pain.Method:Collect 85 cases diagnosed by MRI of the lumbar vertebral end plate osteochondritis of the image data,the performance of their retrospective analysis of MR,male 55 cases,the incidence rate of about 65%;and 30 females,the incidence rate of about 35 %.Results:All the vertebral end plate osteochondritis cases,can show different degrees of disc degeneration or swelling(sudden) the performance of the disc and adjacent vertebral edge patchy,abnormal signal lesions of flaky,T1WI sequences showed low signal or high signal,T2WI showed high signal or low sequence signal,TIRM sequence showed low signal or other signals.63 cases shows Schmorl nodules broke into the vertebral body was button-like defects.According to Modic and other degenerative diseases of the intervertebral disc degeneration of the cartilage end-plate standard type,85 cases in,Ⅰ-type cases,6 cases of the disease accounts for about 7%;Ⅱ-type cases in 70 cases,accounting for lesions 83%;Ⅲ 9 cases of type type,accounting for 11% of lesions.69%(85/59 patients) in patients with end-plate cartilage inflammation low back pain symptoms,including bone marrow type Modic1 type,Schmorl nodules with surrounding Modic1 type,disc-type patients with low back pain were significantly higher than other types,Modic1 type end board after conservative treatment completely or partially converted to Modic2 type,low back pain symptoms were relieved or disappeared,while Modic2 type cases were followed up MRI findings and clinical symptoms remain stable.Conclusion:The lumbar endplate cartilage inflammation is a manifestation of disc degeneration,low back pain is caused by one of the reasons local,MRI is the best means of inspection.