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The comparative study of radiograph, MRI and pathology in degeneration of lumbar intervertebral disc
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 9
- DOI:
- 10.3760/j.issn:1005-1201.2002.09.014
- Key Word:
- 椎间盘;诊断显像;病理学;对比研究
Abstract： 目的观察腰椎间盘退变的病理变化及其MRI表现.方法 13具腰椎尸检标本共31个椎间盘均进行X线钼靶检查,其中5具标本的20个椎间盘进行MR检查,将X线及MRI所见与31个椎间盘的87个层面的病理大切片进行对照.结果 31个椎间盘病理均可见不同程度的纤维环退变,在T2WI上20个椎间盘的内外纤维环中均出现带状、片状高信号,或椎间盘大部呈高信号.病理见22(22/31)个纤维环成角折曲突向髓核(内折),18(18/31)个纤维环成角折曲突向周边(外折);在T1W1和T2WI内折表现为椎间盘内突向髓核成角折曲的低信号,外折表现为椎间盘内突向周边的折角低信号.病理见20(20/31)个椎间盘髓核内可见坏死的细胞碎渣,在T2WI表现为髓核中斑点状低信号(14/20).Schmorl结节见于7个椎间盘,病理显示为椎间盘内的组织突破软骨终板进入椎体内形成结节,7个Schmorl结节在T2WI均呈高信号.病理显示2个椎间盘纤维环内有大的裂隙形成,在T2WI表现为低信号带.病理显示6个椎间盘退变,纤维组织增生呈团块状、分支状和带状横贯于椎间盘之中,在T2WI表现为椎间盘中低信号带.平片示唇样增生3个椎体,Schmorl结节7个椎体;椎体上下面骨板硬化,呈弧形凹陷和锯齿状骨质侵蚀11个椎体,后者病理见凹陷处软骨板消失.结论MRI对腰椎间盘退变有较高的诊断价值,X线平片可以间接显示软骨终板的消失.
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