MRI对腰椎Modic改变终板硬化诊断价值的初步探讨

Study on vertebral endplate signal changes (modic changes):value of MRI in detecting endplate sclerosis of lumbar spine

目的:评价腰椎不同分型Modic改变中是否存在终板硬化和MRI诊断终板硬化的能力。方法:回顾性分析68例患者脊椎腰段(L3～S1)的影像学资料,阅片分析MRI图像上Modic改变和CT片上终板硬化情况;记录ModicⅠ和Ⅱ型中T1、T2信号强度及CT值。结果:共发现35例患者MRI显示有78个终板发生Modic改变,Ⅰ型13%,Ⅰ/Ⅱ混合型12%,Ⅱ型66%,Ⅱ/Ⅲ混合型8%,Ⅲ型1%;36%的终板Modic改变CT显示存在硬化,尤其是Ⅰ/Ⅱ和Ⅱ/Ⅲ混合型。结论:终板硬化不仅存在于ModicⅢ型改变,可存在于所有分型,尤其是混合型,MRI不能显示终板硬化,可能取决于骨髓无活动性矿物质子含量。

Objective：The purpose of our study was to evaluate whether the presence of endplate sclerosis in different Modic types of lumbar spine and to assess the detecting capability of MRI for this surpose.Methods：The imaging data of lumbar spines（L3~S1）of 68 patients were retrospectively reviewed to determine Modic changes and disc degeneration on MRI and endplate sclerosis on CT.T1WI-and T2WI signal intensities on MRI and Hounsfield units（HU）on CT scan measurements of type Ⅰ and Ⅱ Modic changes were recorded.Results：Altogether 78 endplatse with changes in 35 subjects were recorded including type Ⅰ 13%,mixed type Ⅰ/Ⅱ 12%,type Ⅱ 66%,mixed type Ⅱ/Ⅲ 8%,and type Ⅲ 1%,36% endplates with Modic changes showed sclerosis on CT scans especially those of Ⅰ/Ⅱ and Ⅱ/Ⅲ mixed Modic types.Conclusion：Endplate sclerosis exists in all types of Modic changes,especially in mixed Modic types,besides that of type Ⅲ.Endplate sclerosis could not be detected on MRI probably due to the presence of inert mineral proton in the bone marrow.