椎体终板骨软骨炎的MRI表现和病理分析.docVIP

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 [摘要]目的: 探讨椎间盘退变致终板炎的MRI表现与病理分析。方法:搜集经临床及影像学确诊的终板炎患者35例，男16例，女19例，年龄41～75岁，平均59岁，分析异常终板及相邻骨质MRI信号特征及相关病理。结果：35例病例中，共累及78个终板，按照不同的MRI表现及病理，将终板骨软骨炎分为4型，伴随退变椎间盘35个,椎间盘突出34个， Schmorl结节10个等。结论：终板炎的磁共振异常信号病理上认为是终板及其下的松质骨损伤及改建，磁共振对终板炎可作出明确的诊断，利于临床制定合理的治疗方案。 [关键词]椎间盘；终板炎；磁共振；病理分析 Analysis on MRI representations of end-plate osteochondritis and Pathological Yang Yan，Huang Xinyuan，Zheng Jikun，Li Guohui，Chen Zhipeng.Department of Radiology,Yunnan hospital of TCM.Kun Min 650021 [Abstract ] 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. [Key word ]Intervertebral disk；osteochondritis；MRI；Pathological analysis 椎体终板骨软骨炎（End- plate Osteochondritis）简称椎体终板炎，是中老年人椎间盘退变的常见合并疾病，好发于颈椎及腰椎,是患者局部疼痛的原因之一，临床易漏诊误诊。MRI具有多方位，多参数的成像特点，对不同类型，不同时期的终板炎的显示具有特征性。部分I型终板炎表现较特殊，易误诊。本文收集35例此病例，探讨该病MRI表现及相关病理，旨在提高终板炎的影像学诊断与鉴别诊断水平。 １ 资料与方法 1.1一般资料　收集我院2010年10月至2011年9月，经临床及影像学确诊的病例35例，男16例，女19例，年龄41～75岁，平均59岁，临床以腰痛，单侧或双侧下肢放射性疼痛，麻木为主要症状,不同程度腰部活动受限就诊，患者均无体温及血象异常，排外急性外伤及恶性肿瘤患者。 1.2 检查方法：采用PHILIPS Achieva1.5T磁共振成像设备，脊柱表面线圈，常规磁共振包括矢状位SE序列T1加权像（TR/TE=400/8）,矢状位TSE序列T2加权像（TR/T