椎体终板骨软骨炎的MRI表现

MRI findings of end-plate osteochondritis in disc degeneration

目的:探讨终板骨软骨炎(终板炎)在脊柱椎间盘退变中的表现及其临床意义。方法:搜集2006年1月～2007年5月椎间盘退变的MRI资料,腰椎673例,颈椎662例,全部病例均有不同的临床症状。分析终板及邻近椎体骨质信号的改变。结果:673例腰椎间盘退变中,192例有椎体终板炎,占28.5%,共累及326个终板;135例有Schmorl结节病灶,其中40例在结节及周围骨质中存在终板炎类似改变。662例颈椎间盘退变中,139例有终板炎,占21.0%,共累及275个终板;29例Schmorl结节中16例在结节及周围骨质中存在终板炎类似改变。按照不同的MRI表现,将终板炎分为4型。结论:终板炎是造成临床局部疼痛的原因之一,MRI是检查本病的最佳方法。临床工作中注意终板炎的存在及其临床意义,将为颈、腰痛疾病的及时诊治提供有益的帮助。

Objective：To discuss the MRI findings and clinical significance of end-plate osteochondritis in disc degeneration. Methods：During the period of May 2006 to 2007, MRI was performed in 673 cases with lumbar disc degeneration and in 662 cases with cervical bones was measured and analyzed.Results： Of 673 cases with lumbar disc degeneration,end-plate osteochondritis was identified in 192 （28.5%）, involving 326 end-plates,and Schmorl＇s nodule was seen in 135 ,of shich 40 showed changes similar to end-plate osteochondritis in the nodules and adjacent bones.Of 662 cases with cervical disc degeneration,end-plate osteochondritis was present in 139 （21.0%）, affecting 275 endp-lates, and Schmorl＇s nodule was demonstrated in 29, of which 16 showed changes similar to end-plate osteochondritis in the nodules and adjacent bones.Based on lesion＇s signal intensity on MRI,end-plate osteochondritis was classified into 4 types. Conclusion：Chnically, end-plate osteochondritis is one of the reasons causing local pain. MRI is the best modality to detect the lesion .In clinical practice, being aware of the possibility of end-plate osteochondritis is helpful for its diagnosis and management.