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脊椎和脊椎间盘变化的同时存在 腰部疼痛患者-深入的特征与同一天的MRI和CT盘谱
Hanna Hebelka1,2, Alfred Erkmar1,3, Helena Brisby1,3
1Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden.
Diagnostics (Basel, Switzerland)
|December 9, 2023
概括
环状裂是腰部疼痛的早期征兆,通常在Modic变化 (MCs) 和严重的端板损伤之前发生. 脊椎硬化很常见的裂,即使没有MCs,表明一个一般的退行过程.
科学领域:
- 放射学 放射学是一门学科.
- 整形外科 整形外科 整形外科
- 脊柱成像技术 脊柱成像技术
背景情况:
- 腰部疼痛 (LBP) 通常与椎间盘和相邻的脊椎的退行性变化有关.
- 了解这些变化的共存和序列,如环状裂,末板变化和Modic变化 (MCs),对于LBP病原发生至关重要.
- 通常需要多种成像方法来充分描述这些复杂的脊柱病理.
研究的目的:
- 在腰部疼痛患者中,研究环状裂,脊椎和端板变化以及Modic变化 (MCs) 之间的共存和相互关系.
- 用先进的成像技术来确定退行性事件的序列.
- 评估CT盘谱和MRI在评估这些脊柱病理方面的诊断效用.
主要方法:
- 62名LBP患者在同一天接受CT听力学和MRI.
- 通过修改的达拉斯盘谱得分 (DDS) 和MRI特征 (Pfirrmann等级,高强度区域[HIZ]) 对204个椎间盘进行了评估,以寻找环状裂.
- 通过MRI和CT,对邻近的脊椎和端板进行了MC,脊椎硬化和端板缺陷评分 (EPS) 的评估.
主要成果:
- 83%的圆盘显示出外环状裂,其中47%是可界限裂.
- 大多数带有可界定裂的圆盘都有中度退行 (Pfirrmann等级≤3,EPS≤2) 和12%显示MCs.
- 硬盘硬盘严重与先进的磁盘退化 (Pfirrmann等级≥4),不可界限的裂和严重的端板损伤 (EPS≥4) 有着强烈的关联.
- 脊椎硬化症在26%的病例中被观察到,经常与环状裂 (97%) 相关,不论MC是否存在.
- 在47%的圆盘中存在HIZ,与可界限和不可界限裂相关.
结论:
- 环状裂似乎是磁盘退化级联的早期事件,通常是显著的末板变化和MCs之前.
- MCs与更先进的磁盘退化和端板损伤阶段有关.
- 脊椎硬化是与环状裂相关的常见发现,这表明它是一般脊椎退化的一个被低估的特征.
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