观察正常成人斜坡骨髓MRI信号

Observation on normal adult clival marrow with MRI

目的分析正常成人斜坡骨髓的MRI信号特点,为临床早期发现颅底疾病侵犯斜坡或其他系统疾病引起斜坡信号改变提供依据。方法回顾性分析592名正常成人颅脑正中矢状面T1WI,按每10岁为一年龄组分为7组。采用多组等级资料比较秩和检验分析不同年龄组间的斜坡骨髓信号差异,用χ2检验分析不同性别间的斜坡骨髓信号差异。将斜坡骨髓信号分为4型:Ⅰ型为完全低信号,Ⅱ型为以低信号为主伴有部分高信号,Ⅲ型为以高信号为主伴有部分低信号,Ⅳ型为完全高信号。结果斜坡Ⅰ型在成人中占有比例较少,仅为2.87%;Ⅱ型占11.66%,多集中在54岁以下年龄组;Ⅲ型占44.59%,在各年龄段中分布比较均衡,在所有统计量中占有比例最大;Ⅳ型占40.88%,在高年龄者中占有比例较大。不同年龄组间的斜坡骨髓信号差异有统计学意义(P<0.01),在Ⅳ型中男女的差异有统计学意义(P<0.05)。结论成人斜坡骨髓信号随着年龄而改变,且存在性别差异。熟悉成人斜坡骨髓信号的分布规律,有助于早期发现颅底疾病侵犯斜坡或其他系统疾病引起斜坡信号改变。

Objective To analyze the features of normal adult clival marrow on MR T1WI,in order to provide clue for early finding invasion of the clivus caused by basal skull diseases or change of signal intensity in the clivus caused by diseases of other systems.Methods Median sagittal MR T1WI of 592 normal adults aged 15-88 years were retrospectively reviewed.All individuals were divided into 7 groups according to age decade.The signal patterns of clivus marrow were classified as four grades：Grade Ⅰ,uniform hypointense signal areas;Grade Ⅱ,mainly hypointense signal areas but with small part of hyperintense signal areas;Grade Ⅲ,mainly hyperintense signal areas but with small part of hypointense signal areas;Grade Ⅳ,uniform hyperintense signal areas.The differences of groups and sexes in clivus bone marrow signal were analyzed with rank sum test and χ2 test.Results Grade Ⅰ type was the least proportion,only about 2.87%.Grade Ⅱ type accounted for 11.66% and especially appeared in the groups below 54 years.Grade Ⅲ type accounted for 44.59% and was the greatest proportion,with a state of relative equilibrium in each group.Grade Ⅳ type accounted for 40.88% and held the greater proportion in the elder age groups.The differences among different age groups were significant（P0.01）.In the Ⅳ type,the difference between the male and female was significant（P0.05）.Conclusion Sgnal intensity of clivus marrow in adults on MR T1WI changes with aging,and the difference between the male and female is significant.Understanding normal appearances of clival marrow related to age is very important for early diagnosing pathologic processes involving clival marrow.