腰椎间盘HIZ分型及相应节段MRI改变相关性研究

Classification of High Intensity Zones of the Lumbar Spine and Their Association with Other Spinal MRI Phenotypes

目的探讨腰椎间盘局限性高信号区(HIZ)的分型特点,并分析腰椎间盘HIZ与相应节段MR异常改变相互性关系。方法回顾性分析407例患者2035个椎间盘完整腰椎MRI影像资料,统计观察HIZ发生率及形态特点,对其进行形态学分型;记录相应节段所有椎间盘、终板形态信号特点,按椎间盘有无HIZ征象分为HIZ组及非HIZ组,行统计学分析。结果407例患者HIZ发生率为32%(n=130),2035个椎间盘中伴HIZ征象共216个,HIZ在矢状位T2WI序列上表现为圆点型、垂直型、水平裂隙型、斜型、膨大型五种形态。HIZ与相应节段腰椎间盘退变、椎间盘膨/突出、终板炎Ⅱ型具有显著相关性(P<0.01)。结论HIZ分型更加能体现椎间盘纤维环撕裂病理组织学特点,HIZ可能是加速相应节段椎间盘退变和终板炎发生的潜在标志物。

Objective To evaluate the morphological characteristics of high intensity zone and explore the correlation with their spinal MRI phenotypes. Methods A total of 2035 discs for 407 subjects were retrospectively analyzed, All subjects had intact lumbar MRI data.The incidence and morphological classification of HIZ were evaluated. All discs were divided into with HIZ group and without HIZ group,The discs and endplate MRI phenotypes were compared between two groups. Results HIZ was noted in 32.0% of subjects(n=130).Of the 2035 discs,,216 discs had HIZ sign. The morphology of HIZ can be divided into five types: round,fissure,vertical,rim,and enlarged. Disc levels with HIZ had significantly more disc bulges/protrusions and disc degeneration,but not extrusions. Modic typeII change was significantly associated with HIZ at the affected vertebral body adjacent to the endplate. Conclusion HIZ classification can better reflect the histopathological features of disc annulus tear, and HIZ may be a potential marker for accelerating disc degeneration and endplate inflammation.