椎体终板骨软骨炎的MRI表现与病理分析.docVIP

椎体终板骨软骨炎的MRI表现与病理分析 - 图文 椎体终板骨软骨炎的MRI表现与病理分析 杨燕 黄信源 郑继坤 李国晖 陈志鹏 Objective:To analyze MRI features of end-plate osteochondritis and Pathological analysis. Methods:Retrospective analysis was made on 35 patients admitted to hospital .The patients included 16 male and 19 female,age from 41 to 75 years with an average of 59 years .The signal changes in end- plate and its adjacent vertebal bones and Pathological were analyzed.Results:of 78 cases,35 patients were diagnosed in end –plate.Based on the MRI feature and Pathological ,4 types endplate chondritis were defined.Accompanied changes :35 cases with lumbar disc degeneration, 34 cases with lumbar disc herniation,and Schmorl’s nodule in 10. Conclusions: Endplate inflammation of magnetic resonance anomalous signals pathology endplate and that is the cancellous bone injury and reconstruction, M RI is the best method in diagnosing endplate osteochondritis，which is helpful in treatment planning for lumbar disc degeneration. Modic将椎体终板炎分为三型：I型，T1加权像上终板及终板下骨表现为低信号，T2 加权像上为高信号，病理学检查表现为水肿，并与终板裂缝和软骨下骨骨髓血管化增加有关，从而延长了椎体T1，T2驰豫时间，同时合并有显微骨折现象；II型，组织学上表现为骨髓脂肪变性或骨髓缺血坏死，导致T1及T2时间缩短，使T1WI为高信号，T2ＷI略高信号；III型，组织学上表现为骨硬化，引起T1弛豫时间延长，T2弛豫时间缩短，故T1WI，T2WI均为低信号，并与平片上致密骨硬化相对应，多见于老年椎体。本文中部分患者出现多发终板病变，各处病程不一, T1WI、T2WI呈混杂信号，提示血管化与黄骨髓化同时存在，同一终板又可演变为不同类型。国内学者将终板炎分为I-IV型，即活动期，移行期，稳定期，痊愈.临床放射学杂志，2003,22（2）:129-132. 4. DeRoos A.MR imaging of marrow changes adjacent to end plates in degenerative lumbar disc disease. AJR,1987,149:531-534. 5. Shaikh MI，Saifuddin A，Pringle J，et a1．Spinal osteoblastoma ：CT and MR imaging with pathological correlation .Skeletal Radiology,2000,29:27 -33. 7. Kuisma M,Karppinen J,Haapea M，et a1．Modic changes intertebral endplates：a comparison of MR imaging and multi-slice CT[ J ].Skelet l Radiology,200 9,38：141 -147.