文献类型：期刊文献

中文题名：腰椎间盘退变在腰椎滑脱中CT、MRI的改变及临床意义

英文题名：CT and MRI changes of lumbar intervertebral disc degeneration in spondylolisthesis and their clinical significance

作者：王琳[1,2];林志艳[2];施乐年[1];李孝忠[1];张洁[1]

第一作者：王琳

机构：[1]甘肃中医药大学附属医院放射科,甘肃兰州730020;[2]甘肃中医药大学临床医学院,甘肃兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2017

卷号：27

期号：8

起止页码：1565

中文期刊名：医学影像学杂志

外文期刊名：Journal of Medical Imaging

收录：CSTPCD

基金：甘肃省卫生行业科研管理项目(编号:GWGL2014-41);甘肃中医药大学中青年科研基金项目(编号:ZQ2014-30)

语种：中文

中文关键词：脊椎滑脱症;椎间盘退变;磁共振成像;体层摄影术,X线计算机

外文关键词：Spondylolisthesis; Intervertebral disc degeneration; Magnetic resonance imaging; Tomography, X-ray computed

摘要：目的分析腰椎间盘退变在腰椎滑脱中CT、MRI的变化,探讨腰椎间盘退变与腰椎滑脱的关系及临床意义。方法回顾分析2015年10月~2017年03月间收治的112例腰椎滑脱患者的CT、MRI资料。在CT上观察椎间盘真空征、许莫氏结节及钙化的情况,在正中矢状位上分别测量椎间盘高度、滑脱角;在MRI图像上评价椎间盘的Pfirrmann分级、突出及软骨终板的Modic改变。结果滑脱椎间盘148个,CT显示:滑脱椎间盘高度L3~4、L4~5、L5~S1的后份较前份窄,L3~4、L4~5、L5~S1滑脱角逐渐变小。真空征69个;许莫氏结节44个;钙化16个;骨质增生72个。MRI显示椎间盘Pfirrmann分级,Ⅱ级15个;Ⅲ级46个;Ⅳ级30个;Ⅴ级11个。终板Modic改变:Ⅰ型15个;Ⅱ型22个;Ⅲ型7个;伴椎间盘突出54个。结论腰椎间盘退变及终板Modic改变与腰椎滑脱在病理上存在互为因果的关系,CT与MRI的结合应用在临床治疗的选择上有较重要指导作用。
Objective To analyze the CT and MRI changes of intervertebral disc degeneration in lumbar spondylolisthesis, and to explore the relationship between lumbar disc degeneration and lumbar spondylolisthesis and their clinical significance. Methods We carryied out retrospective analysis to the data of CT and MRI in 112 patients with lumbar spondylolisthesis treated from October 2015 to March 2017, observed the intervertebral disc vacuum syndrome, schmorl snode and calcification in CT, measured the height of intervertebral disc and slip angle in midst sagittal plane respectively, and evaluated the pfirrmann scale and protruding of intervertebral disc and Modic changes of cartilage endplate in the MRI . Results There were 148 spondylolisthesis intervertebral discs, the CT image displayed that the posterior part of slip disc height of L3 - 4, L4- 5 and L5 - S1 was narrower than the anterior part, the slip angle of L3- 4, L4 - 5 and L5 - S1 had become smaller. Among them, there were 69 vacuum signs, 44 schmorl snodes and 16 calcifications. The MRI images showed that the intervertebral disc Pfirrmann scale, there were 15 scale II, 46 scale III, 30 scale IV and 11 scale V. Modic changes of endplate showed 15 in type I, 22 in type II, 7 in type III; there were 54 disc herniation. Conclusion The lumbar intervertebral disc degeneration and changes of endplate Modic are the cause-and-effect relation with lumbar spondylolisthesis, the combination of CT and MRI has an important guiding role in the selection of clinical treatment methods.