Haughton Victor
Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA.
J Bone Joint Surg Am. 2006 Apr;88 Suppl 2:15-20. doi: 10.2106/JBJS.F.00010.
Magnetic resonance imaging provides excellent anatomic detail of spinal tissues, but fails to provide the type of information that permits a definitive diagnosis in many patients with back pain. New imaging strategies that can be applied to the study of intervertebral disc degeneration include diffusion-weighted imaging, magnetic resonance imaging, diffusion tensor imaging, magnetic resonance spectroscopy, functional magnetic resonance imaging, dynamic computed tomography and magnetic resonance imaging, and T2 relaxometry. With dynamic imaging, the relative motions of normal and degenerated lumbar motion segments can be evaluated noninvasively. With further evaluation of the technique, hypermobile segments may be distinguishable from those with normal relative motion. T2 measurements obtained by T2 relaxometry appear to have important advantages with regard to spinal imaging because this modality provides a continuous and objective measure of the content of free water in the disc, which decreases with aging and degeneration. Anatomic imaging of the spine is highly accurate in the evaluation of nonmechanical causes of back pain and less beneficial in the evaluation of back pain that is due to mechanical causes. The development of functional imaging strategies of the spine will likely improve the management of patients with back pain. This article outlines the current magnetic resonance imaging protocols for intervertebral disc degeneration, indicates deficiencies in current imaging, and describes functional imaging strategies for the spine that will likely improve the evaluation of patients with back pain. It also reviews recent published articles on magnetic resonance imaging and computed tomographic imaging of the spine and details the results of studies that have explored the future potential of spine imaging.
磁共振成像能提供脊柱组织出色的解剖细节，但在许多背痛患者中无法提供做出明确诊断所需的信息类型。可应用于椎间盘退变研究的新成像策略包括扩散加权成像、磁共振成像、扩散张量成像、磁共振波谱、功能磁共振成像、动态计算机断层扫描和磁共振成像以及T2弛豫测量法。通过动态成像，可以无创地评估正常和退变腰椎运动节段的相对运动。随着对该技术的进一步评估，活动度过高的节段可能与相对运动正常的节段区分开来。通过T2弛豫测量法获得的T2测量值在脊柱成像方面似乎具有重要优势，因为这种方式能提供椎间盘内自由水含量的连续且客观的测量值，而该含量会随着衰老和退变而降低。脊柱的解剖成像在评估非机械性背痛原因时高度准确，而在评估机械性背痛时益处较小。脊柱功能成像策略的发展可能会改善背痛患者的治疗。本文概述了目前用于椎间盘退变的磁共振成像方案，指出了当前成像的不足之处，并描述了可能会改善背痛患者评估的脊柱功能成像策略。它还回顾了最近发表的关于脊柱磁共振成像和计算机断层扫描成像的文章，并详细介绍了探索脊柱成像未来潜力的研究结果。
