中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (52): 9737-9743.doi: 10.3969/j.issn.2095-4344.2012.52.010

• 脊柱植入物 spinal implant • 上一篇    下一篇

腰椎间盘退变MRI：与Modic改变相关的影像学分析

刘珍珍1，陈建宇1，钟镜联1，蒋新华2，蔡兆熙1，张 娅1，杨泽宏1，雷立昌1   

  1. 1中山大学附属孙逸仙纪念医院放射科，广东省广州市 510120
    2中山大学附属肿瘤医院影像与微创介入中心，广东省广州市 510060
  • 收稿日期:2012-05-04 修回日期:2012-06-15 出版日期:2012-12-23 发布日期:2012-12-23
  • 通讯作者: 陈建宇，硕士，教授，中山大学附属孙逸仙纪念医院放射科，广东省广州市 510120 chenjianyu5562@163.com
  • 作者简介:刘珍珍★女，1986年生，山西省临汾市人，中山大学在读硕士，主要从事肌骨系统影像诊断的研究。 zhenzhen1017@yeah.net

Magnetic resonance imaging of lumbar intervertebral discs degeneration：Analysis of the imaging manifestations related to Modic changes

Liu Zhen-zhen1, Chen Jian-yu1, Zhong Jing-lian1, Jiang Xin-hua2, Cai Zhao-xi1, Zhang Ya1, Yang Ze-hong1, Lei Li-chang1   

  1. 1Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
    2Department of Medical Imaging & Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
  • Received:2012-05-04 Revised:2012-06-15 Online:2012-12-23 Published:2012-12-23
  • Contact: Chen Jian-yu, Master, Professor, Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China chenjianyu5562@163.com
  • About author:Liu Zhen-zhen★ Studying for master’s degree, Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China zhenzhen1017@yeah.net

PDF

547

摘要：

背景：部分椎间盘源性下腰痛患者MRI可出现Modic改变，但Modic改变的相关因素及Modic改变与椎间盘退变之间因果关系目前尚不十分清楚。
目的：分析存在腰椎间盘Modic改变的下腰痛患者性别、年龄分布特点及腰椎间盘发生Modic改变的相关因素。
方法：回顾性分析634例(2 536个椎间盘)存在腰椎间盘Modic改变患者的性别、年龄分布特点，并分析腰椎间盘Modic改变与椎间盘突出或膨出、Schmorl结节、椎体滑脱、椎间盘解剖水平及椎间盘退行性改变程度的相关性。
结果与结论：634例患者中，女性患者ModicⅡ、Ⅲ型出现率均较男性高，而ModicⅠ型出现率小于男性患者(P < 0.001)；40岁以上患者较40岁以下患者Modic各型改变的出现率均高(P < 0.001)。2 536个腰椎间盘中，有椎体滑脱、出现Schmorl结节、有椎间盘突出或膨出者Modic各型改变的出现率均比无此类表现者高(P < 0.001)；L4/5、L5/S1水平(低位)Modic各型改变的出现率均比L2/3、L3/4水平(高位)高(P < 0.001)；椎间盘退行性改变越严重，Modic各型改变的出现率越高(P < 0.001)。椎间盘退行性改变分级、Schmorl结节与Modic改变有显著相关性。结果说明，腰椎间盘Modic改变与患者性别、年龄、椎间盘有无突出或膨出、有无Schmorl结节、椎体有无滑脱、椎间盘解剖水平及椎间盘退行性改变分级均有相关性。其中，椎间盘退行性改变分级、Schmorl结节与腰椎间盘Modic改变间的相关性最高，且椎间盘退行性改变分级较Schmorl结节与之相关性更高。

关键词: 腰椎间盘, 退行性改变, Modic改变, MRI, Logistic多重回归分析

Abstract:

BACKGROUND: Part of the discogenic low back pain patients’ MRI shows Modic changes, but the relevant factors of Modic changes and the causal relationship between Modic changes and disc degeneration remain unclear.
OBJECTIVE: To explore the distribution of the Modic changes of lumbar intervertebral discs in patients (gender and age) suffering low back pain and to explore the correlated factors of the Modic changes.
METHODS: 634 patients (2 536 lumbar intervertebral discs) suffering low back pain were examined by Magnetic resonance imaging scan. The distribution character of the Modic changes of lumbar intervertebral discs among different ages and between different genders were analyzed, and the correlation between Modic changes and lumbar intervertebral disc herniation, Schmorl nodes, lumbar instability, lumbar segments, and the degeneration degree of lumbar intervertebral discs were analyzed, too.
RESULTS AND CONCLUSION: Among 634 patients, the occurrence rate of Modic Ⅱ and Modic Ⅲ in female was higher than that in male, but the occurrence rate of Modic I in female was lower than that in the male (P < 0.001). The occurrence rates of Modic Ⅰ-Ⅲ among people over 40 years were higher than that in people aged under 40 years (P < 0.001). Among 2 536 lumbar discs, the occurrence rates of Modic Ⅰ-Ⅲ among people who have lumbar instability or Schmorl nodes or lumbar intervertebral disc herniation were all higher than those in the people who do not have the performance (P < 0.001). The occurrence rates of ModicⅠ-Ⅲ in the segment L4/5 and L5/S1 (the lower level) were higher than those in the segment L2/3 and L3/4 (the higher level) (P < 0.001). The more serious the lumbar discs degeneration changes are, the higher the occurrence rates of Modic Ⅰ-Ⅲ will be (P < 0.001). There were markedly correlation among the degeneration degrees of lumbar intervertebral discs, Schmorl nodes and Modic changes. There are correlations between Modic changes and patients’ age, patients’ gender, lumbar intervertebral disc herniation, Schmorl nodes, lumbar intervertebral instability, lumbar segments, and the degeneration degree of lumbar intervertebral discs. The degeneration degrees of lumbar intervertebral discs and Schmorl nodes have highly correlation with Modic changes, and the degeneration degree of lumbar intervertebral discs has a higher correlation with Modic changes than Schmorl nodes.

中图分类号: