椎间盘退变的磁共振成像研究进展

Advanced study of intervertebral disc degeneration with MRI

随着影像学成像理念的革新、设备的发展,椎间盘退变(intervertebral disc degeneration,IVDD)的MRI成像研究近几年获得了较大的进展。较新的MRI成像策略包括:动态成像、弥散加权成像、弥散张量成像、磁共振波谱成像、MR-T1ρ成像和T2驰豫时间的测量。MRI动态成像能够检出活动度过大的节段脊柱;弥散加权成像可定量研究活体组织内水分子扩散程度,在研究椎间盘疾病发病机制、无创评价治疗效果,以及预后判断等方面具有潜在应用价值;弥散张量成像可能是有效展示椎间盘早期退变的一种可靠方法;磁共振波谱成像评价早期椎间盘退变有重要价值;T2弛豫时间正常椎间盘与退变椎间盘只存在略微差别,要想将T2弛豫时间用于定量分析IVDD尚需进一步的研究。上述各种磁共振最新的成像技术,因能够无创性定量评价椎间盘早期退变并进行分期为临床决策提供更多可靠的影像学证据而成为当今研究热点。本文就当前IVDD的MRI成像进展和前景进行综述。

As the innovation of medical imaging and the development of equipment, the research on the MRI of intervertebral disc degeneration has been greatly improved these years. The new MRI imaging strategies include diffusion weighted imaging,diffusion ten- sor imaging, magnetic resonance spectroscopy, functional magnetic resonance imaging, dynamic magnetic resonance imaging,T2 relaxom- etry and spin-lock T~ p-weighted MRI. Dynamic magnetic resonance imaging can distinguish the active spine ; diffusion weighted imaging can quantitatively study the degree of living tissue inland molecular diffusion. It shows potential application value in the aspects of in- tervertebral disease pathogenesis, effects of non-invasive treatment and prognosis. Diffusion tensor imaging may effectively show early degeneration of intervertebral disc degeneration. Magnetic resonance spectroscopy imaging shows great value of early disc degeneration. There is tiny difference between T2 relaxation time of normal and intervertebral disc degeneration. It needs further study on applying Tz relaxation time in the quantitative analysis of IVDD. All of the above new imaging techniques of MRI have been heatedly studied be- cause they can non-invasively and quantitatively evaluate early intervertebral disc degeneration and provide more reliable evidences of imaging for clinical decisions by stages. This article summarizes the development and prospects of current magnetic resonance imaging of IVDD.