腰椎间盘局限性高信号区（HIZ）的发生与分布规律.DOCVIP

临床医学论文-腰椎间盘局限性高信号区（HIZ）的发生与分布规律 ?????????? 作者：王子轩，胡有谷，陈祥民? 【摘要】? ［目的］探讨腰椎间盘局限性高信号区（HIZ）的发生与分布规律。［方法］回顾性分析1 000例腰椎MRI资料。对HIZ进行立体定位并分析其发生与分布规律。采用SPSS 11.0对所得数据进行统计学分析。［结果］本组HIZ发生率46.7％（前缘21.5％，后缘31.7％），共650个。其中，左侧238个（36.7％），右侧220个（33.8％），无明显侧别差异（x2=1.0 922，P＞0.05）。下缘446个（68.6％），明显多于中部及上缘。HIZ好发节段为L3、4～L5S1，可单发或多节段同时发生。其中，前缘HIZ多见于L2、3和L3、4椎间盘，后缘HIZ好发于L4、5和L5S1水平。［结论］腰椎间盘HIZ发生率较高。常见于椎间盘后缘、下缘和下腰椎。可单节段发生，亦可同时发生于多个节段。 【关键词】? 椎间盘； 磁共振； 高信号区； 流行病学 ??? Abstract：［Objective］To explore the prevalence and distribution of High-intensity Zone（HIZ）in lumbar disc.［Method］Magnetic resonance images of 1 000 lumbarintervertebral discs were retrospectively analyzed.The HIZs founded in this sample were located in 3 dimensions and analyzed for its developing and distributing characters.All data were analyzed with SPSS software.［Result］The incidence rate of HIZ was 46.7%（in anterior annulus fibrosus AF 21.5%,in posterior AF 31.7%）and the sum total were 650.The distribution showed no difference（x2=1.0 922,P＞0.05）between left AF（238,36.62%）and right AF（220,33.85%）.More HIZs（446,68.62%）were located in inferior AF than that of middle or superior AF.The motion segments from L3、4 to L5S1 were the region that the HIZ occurred frequently and it could present in single segment or multi-segment.In anterior AF,HIZs often occurred at L2、3 and/or L3、4 discs.Whereas,they usually developed at L4、5 and/or L5S1 in posterior AF.［Conclusion］The incidence rate of HIZ in lumbar disc is higher.Posterior and inferior AF of discs and lower motive segments have more risk of HIZs.It could develop in single motive segment or multi-segments at one time. ??? Key words:intervetebral disc;? MRI;? high-intensity zone;? epidemiology ??? 腰椎间盘局限性高信号区（high-intensity zone，HIZ）是MRI T2加权像中椎间盘后缘的1个高信号区，其周围由低信号包绕。Aprill和Bogduk〔1〕首先注意到HIZ与椎间盘造影中一致性疼痛之间的关系。他们认为HIZ是一个有价值的疼痛性破裂椎间盘的标志。与传统的椎间盘造影〔2、3〕相比，具有无创的优点和较高敏感性。此后，学者们围绕HIZ开展了大量研究，但研究对象均为后缘HIZ且未见有关发生率和三维分布的大样本研究报道。本文系统地回顾了1 000例随机抽取的腰椎MRI资料，对HIZ的发生规律与分布特点进行分析，统计了腰椎间盘前缘HIZ的发生率，以期为临