腰椎间盘积气的多层螺旋CT表现及其相关因素分析

Multislice spiral CT manifestations and correlation analysis of lumbar intervertebral disc pneumatosis

目的探讨腰椎椎间盘积气的发生率、发病部位、CT表现及其与年龄、性别因素的相关分析。方法回顾性分析868例腰椎检查者、206例313个腰椎间盘积气患者的多层螺旋CT表现,按性别、年龄及其发生椎间盘层面进行分组,观察椎间盘积气的发生率、发生部位、CT表现及与性别、年龄的关系。结果 868例中206例有椎间盘积气,发生率为23.7%,其中男性、女性发生率分别为21.1%(84/399)和26.0%(122/469),性别间差异无统计学意义(χ2=2.93,P=0.087)。CT表现形态各异,为小泡状、小条状、不规则片状。<30、30～39、40～49、50～59、60～69和≥70岁年龄组的积气发生率依次为0、6.7%(10/150)、12.5%(23/184)、23.7%(55/232)、45.0%(58/129)和68.2%(60/88),各年龄组之间椎间盘积气发生率具有统计学差异(χ2=191.6,P=0.000)。L5/S1、L4/5、L3/4、L2/3和L1/2椎间盘积气的发生率分别为10.8%(94/868)、8.1%(70/868)、6.0%(52/868)、6.6%(57/868)和4.6%(40/868),各椎间盘之间积气发生率具有统计学差异(χ2=29.185,P=0.000)。结论腰椎椎间盘积气发生率约为23.7%,且随年龄增加而增高,但男女发生率无差别。腰椎间盘积气发生率从L5/S1到L1/2依次递减。根据椎间盘内气体密度,MSCT可准确判断椎间盘积气。

Objective To discuss the total incidence, position, CT features and age- and gender-related changes of lumbar intervertebral disc pneumatosis. Methods CT images of 868 patients who had lumbar muhislice CT,included 206 patients 313 lumbar intervertebral discs which were found gas were retrospectively analyzed. CT features and incidence of gas existed in lumbar intervertebral disc in different gender, age group and lumbar intervertebral disc were recorded. So as to observe the total incidence, position and CT features of lumbar intervertebral disc pneumatosis with patients age and gender. Results All of 868 patients, there were 206 cases who were found gas existed in lumbar intervertebral disc. The total incidence of lumbar intervertebral disc pneumatosis was 23.7%. The incidence of male and female were 21.1% （84/399）and 26% （122/469）. There was not significantly difference between male and female（x^2 = 2. 93 ,P = 0. 087 ）. There were all kinds of forms of the gas which existed in lumbar intervertebral disc, including vesicular, stripe and irregular flake-like, et al. The influence for age 〈30,30-39,40-49,50-59,60-69 and 〉 70 were 0% ,6.7% （ 10/150）, 12. 5% （23/184） ,23.7% （55/232）, 45% （58/129）and 68.2% （60/88）, respectively. There were significantly difference between age groups （x^2 = 191.6 ,P = 0. 000）. The incidence of lumbar intervertebral disc pneumatosis of L5/S1,L4/5, L3/4, L2/3 and L1/2 were 10. 8% （94/868）, 8. 1% （70/868）, 6% （52/868）, 6. 6% （57/868）and g. 6% （40/868）, respectively. There was significantly difference between them （ x^2 = 29. 185, P = 0. 000）. Conclusion The total incidence of lumbar intervertebral disc pneumatosis is 23.7% ,which is increased with aging but not with gender. Its currence is decresed from L5/S1 to L1/2 level. According to the gas density, MSCT can accurately judge the gas existed in lumbar intervertebral disc.