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目的探讨低场磁共振(MR)诊断腰椎终板软骨炎患者的价值及其相关磁共振成像的特点。方法将2012年9月至2014年2月期间于骨科门诊或病房住院治疗的100例腰椎终板软骨炎患者作为研究对象,收集相关MR影像学资料,分析其在低场MR影像表现特点,并跟据并发腰椎间盘病变与否分为A组(并发腰椎间盘)和B组(无明显腰椎间盘病变),观察两组患者在不同分型系统中的阳性率。结果 100例腰椎终板软骨炎患者多数并发腰椎间盘病变,多数病变累及L4-5或者L5~S1。100例患者有52例合并腰椎间盘病变(A组),其中膨隆型5例、突出型39例、脱垂游离型5例以及Schmorl结节3例,其余48例患者均无明显腰椎间盘病变(B组)。A组患者Modic分型系统阳性率与国内分型系统阳性率差异无统计学意义(χ2=1.29,P=0.23)。B组患者Modic分型系统阳性率与国内分型系统阳性率差异有统计学意义(χ2=11.01,P=0.001)。结论腰椎终板软骨炎患者低场MR表现多数合并腰椎间盘病变,并且多数累计L4-5或L5~S1,腰椎终板软骨炎患者采用Modic分型系统能在一定程度上提高阳性诊断水平(无明显腰椎间盘病变),采用国内腰椎软骨炎分型系统能在一定程度上明显提高合并腰椎间盘病变的终板软骨炎患者的阳性率,但差异不明显。
Objective To investigate the value of low field magnetic resonance (MR) in the diagnosis of patients with lumbar endplate chondritis and its related characteristics of magnetic resonance imaging. Methods One hundred patients with lumbar endplate chondritis who were hospitalized in orthopedic clinic or ward from September 2012 to February 2014 were selected as research objects. Relevant MR imaging data were collected and analyzed for their MR imaging features at low field. According to the concomitant lumbar disc disease or not, the patients were divided into group A (with lumbar intervertebral disc) and group B (with no obvious lumbar disc disease). The positive rates of the two groups in different typing systems were observed. Results 100 cases of lumbar endplate chondritis most patients with lumbar disc disease, most lesions involving L4-5 or L5 ~ S1.100 cases of 52 patients with lumbar disc disease (group A), including bulging in 5 cases, prominent 39 In 5 cases of prolapsed free type and 3 cases of Schmorl nodules, the remaining 48 cases showed no obvious lumbar disc disease (group B). There was no significant difference between the positive rate of Modic typing system and the positive rate of typing system in China (χ2 = 1.29, P = 0.23). There was significant difference between the positive rate of Modic typing system in B group and the positive rate of typing system in China (χ2 = 11.01, P = 0.001). Conclusions The low-field MR manifestations of lumbar end-stage chondritis are mostly associated with lumbar disc disease. Most patients with L4-5 or L5-S1 cumulative lumbar endplate chondritis may use Modic system to improve the positive diagnosis to a certain extent Obvious lumbar disc disease), the use of the domestic lumbar chondritis classification system can be significantly improved in some patients with lumbar disc disease in end-stage chondritis patients positive rate, but the difference was not significant.