腰椎终板Modic改变与椎间盘退变的相关性的定量MRI研究

摘要

Objective: To investigate the relationship between vertebral endplate Modical changes and adjacent intervertebral disc degeneration. Materials and Methods: Lumbar structure and quantitative MR images of 66 patients were retrospectively analyzed. Disc degeneration was semi-quantitatively assessed using Pfirrmann grading system and quantitatively assessed using T2 and T2* values. Association between Pfirrmann scores, T2 and T2* values of intervertebral discs with adjacent endplate Modic changes was analyzed. Results: Nineteen intervertebral discs with adjacent endplate Modic changes were detected in fourteen patients (14/66, 21.2%), which included 2 discs with Modic type 1 changes and 17 discs with type 2 changes. Pfirrmann scores of the discs adjacent to normal endplates, Modic type 1 endplates and Modic type 2 endplates were 2.40±0.96、4±1.41 and 4.12±1.27, respectively. T2 values were (95.38±51.88) ms, (70.50±36.06) ms and (58.65± 38.47) ms. T2* values were (34.43±19.16) ms, (24.00±1.41) ms and (28.65±23.00) ms. The differences of disc Pfirrmann scores, T2 and T2* values among different endplate changes were statistical significant with P values of 0.000, 0.000 and 0.023, respectively. Comparing to discs adjacent to normal endplates, discs adjacent to Modic type 2 endplates had severe degeneration with increased Pfirrmann scores and decreased T2 and T2* values. The differences were statistical significant (P values were 0.000, 0.000 and 0.006, respectively). Conclusions: Modic changes of vertebral endplate are associated with adjacent intervertebral disc degeneration. Both of them should be regarded as a facet of the "whole-organ" pathologic conditions in the procession of spinal degeneration.%目的 探讨腰椎终板Modic改变与相邻椎间盘退变的相关.材料与方法 于66例腰椎结构和定量MR图像上,采用Pfirrmann分级半定量和测量椎间盘T2和T2*值定量评价椎间盘退变程度,比较腰椎终板Modic改变与椎间盘Pfirrmann评分、T2和T2*值的相关性.结果 66例患者中,14例患者(21.2%)终板有19个椎间盘相邻的终板有Modic改变,包括2个椎间盘相邻的终板为Modic 1型改变,17个椎间盘相邻的终板为Modic 2型改变.正常终板、Modic 1型终板和Modic 2型终板相邻椎间盘的Pfirrmann评分分别为2.40±0.96、4.00±1.41和4.12±1.27,T2值分别为(95.38±51.88)、(70.50±36.06)和(58.65±38.47)ms,T2*值分别为(34.43±19.16)、(24.00±1.41)和(28.65±23.39)ms,差异均有统计学意义(P值分别为0.000、0.000和0.023).Modic 2型终板相邻的椎体伴有严重的椎间盘退变(Pfirrmann评分升高,T2和T2*值降低),与正常终板相邻的椎间盘比较,差异具有统计学意义(P值分别为0.000、0.000和0.006).结论 腰椎终板Modic改变与相邻的椎间盘退变具有相关性,终板改变和椎间盘退变应作为腰椎退变的整体改变.