DWI对腰椎Modic改变Ⅰ型应用价值初步探讨

The application value of magnetic resonance diffusion-weighted imaging in diagnosing vertebra modic changesⅠ

目的探讨Modic改变Ⅰ型MR扩散加权成像信号改变并测定、分析其ADC值,推断MR信号无异常但已有组织学变化的Modic改变Ⅰ型潜伏期ADC值改变,以期早诊断、早发现、早干预,延缓向Modic改变进程。方法回顾性分析我院2012年3月～2013年4月收集的经临床及MRI诊断为腰椎Modic改变Ⅰ型患者40例,MRI扫描技术为常规MR序列加矢状位DWI序列,b值分别取150、350、500s/mm2,然后按照性别、年龄段进行分组,并对30例健康志愿者行常规MR扫描及矢状位DWI检查。结果 40例共累计终板80个,在DWI图像上表现为条状或斑片状高信号; b值为500s/mm2时,因图像质量较差摒除计算,对b值为150、350s/mm2时进行统计分析。其中男性24例,女性16例,3个年龄段<40岁,40～60岁,> 60岁人数分别为10、16、14例,性别、年龄因素对Modic改变Ⅰ型ADC值造成的差异没有统计学意义(P> 0. 05),正常椎体在DWI图像上表现为低信号,Modic改变Ⅰ型与正常椎体的ADC值有明显统计学意义(P <0. 001)。结论 DWI不仅能显示椎体Modic改变Ⅰ型,并能定量分析ADC值,对临床分析Modic改变提供了一个定量诊断思路。

Objective To discuss the modic changes Ⅰ of lumbar vertebr a characteristic in magnetic resonance diffusion-weighted imaging, to measure apparent diffusion coefficient (ADC) values, thas evaluating the clinical application value. Methods 40 cases of modic changesⅠdiagnosed by clinical materials and MRI were reviewed retrospectively in our hospital. MRI contained routine and sagittal DWI sequences, b-value was 150, 350, 500 s/mm 2. Modic changes Ⅰ were divided into two groups by gender, divided into three groups by age:<40, 40~60,>60. Results 40 cases of Modic changes involved 80 end-plates, with Strip or patchy high signal. The contrast and sensitivity of the image signals were better while b was 150, 350 s/mm 2. Data analyzed while b was 150, 350 s/mm 2. There were no significant difference existed between groups of Modic changes divided by gender, age ( P >0.05). Conclusion DWI could reveal the changes of the vertebral body signals, and offer ADC value, DWI would be a quantitative supplementary means in diagnosing the Modic change.