弥漫性特发性骨质增生症脊柱影像学表现

Study on Imaging Findings of DISH

目的分析弥漫性特发性骨质增生症（DISH）脊柱影像学特征。方法对DISH35例行x线检查，其中33例行CT扫描，30例行MRI扫描，分析比较其影像学特征。结果脊柱x线表现为前纵韧带广泛流注样钙化，韧带附着部椎体边缘骨质增生。髂腰韧带和髋关节异位钙化5例，后纵韧带骨化3例，左上肺复发性肺炎1例。前纵韧带骨化表现为连续波浪状致密影（I型，23例）和呈断续状致密影（II型，12例）。CT表现受累椎体前外侧呈结节型、连续型和混合型钙化；颈椎体前缘骨赘指向下11例，腰椎体前缘骨赘指向上15例。MRI表现：17例椎体前、外侧缘和3例椎体后缘于T1WI和T2wI带状低信号影，19例继发椎管狭窄，其中3例脊髓内见点片状稍长T1和长T2信号。结论提高对DISH脊柱影像学特征识别，理解DISH可能是病人产生症状的原因，有助于临床诊断和治疗。

Objective To analyze spinal imaging findings of DISH. Methods Collected 35 cases of DISH with all X - ray examinations and 33 CT scans and 30 MR scans, analyzed their imaging character- istics retrospectively. Results Our study was all of middle - elder people, male predominance,. 24 blood serum examples on HLA - B27 were negative. The X - ray findings of spinal DISH showed streamline ossifications or calcification of anterior longitudinal ligament, hyperostosis at spinal margin attached ligament, 5 cases ectopic calcification of iliolumbar ligament and hip joint, 3 cases posterior longitudinal ligament ossification, one case relapsed pneumonia. Anterior longitudinal ligament ossification presented continuous wavilness compact shadow （I -type, 23 cases） and interrupt compact shadow （ 11 -type, 12 cases）. CT findings of spinal DISH showed nodule, continuous, mixed - type calcification at spinal anterolateral margin. Cervical osteophyte of 11 cases directed downward, but lumbar osteophyte of 15 cases directed upward. MRI findings of spinal DISH showed stripe low density at spinal anterolaerial or posteri- or margin on T1WI and T2WI. 19 cases presented spinal stenosis with 3 cases mildly long T1 and long T2 signal in spinal cord. Conclusion Identifying DISH imaging features and understanding DISH causes are going to help to guide DISH clinical diagnosis and therapy.