Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
Spine (Phila Pa 1976). 2011 Feb 1;36(3):E198-202. doi: 10.1097/BRS.0b013e3181d5ff05.
A retrospective observational study of healthy volunteers and patients with degenerative and infectious endplate abnormalities in the lumbar spine.
Our purpose was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differentiation of degenerative and infectious endplate abnormalities using 1.5-T magnetic resonance imaging (MRI).
DWI can provide valuable structural information about tissues that may be useful for clinical applications in differentiation between degenerative and infectious endplate abnormalities.
Sixteen consecutive patients with endplate abnormalities that was detected by MRI of the lumbar spine, and 15 healthy volunteers were studied. DWI was performed using whole-body imaging with background body signal suppression with a b value of 1000 s/mm2. Apparent diffusion coefficient values of normal and abnormal vertebral bone marrow were calculated.
Twenty-nine vertebral abnormalities were found in 16 patients. Nine vertebral abnormalities in 5 patients were because of infections and 20 vertebral abnormalities in 11 patients were because of degenerative changes; 7 levels were classified as Modic type 1, 7 levels as type 2, and 6 levels as type 3. DWI showed hyperintensity in all patients with infection, similar to that used in positron emission tomography, but not in the intervertebral spaces of any patients with degenerative disease. Apparent diffusion coefficient values of infectious bone marrow were significantly higher than normal and degenerative bone marrow.
DWI is useful for differentiation of degenerative and infectious endplate abnormalities. Moreover, MRI is widely used clinically because of the lack of ionizing radiation, low cost, and fast imaging time as compared with positron emission tomography. Therefore, DWI has the potential to be used as a screening tool.
一项回顾性观察研究，纳入了健康志愿者以及患有腰椎退行性和感染性终板异常的患者。
我们旨在评估使用 1.5T 磁共振成像（MRI）对退行性和感染性终板异常进行扩散加权成像（DWI）的有用性。
DWI 可以提供关于组织的有价值的结构信息，对于区分退行性和感染性终板异常的临床应用可能有用。
研究纳入了 16 例经腰椎 MRI 检查发现终板异常的连续患者和 15 名健康志愿者。使用全身成像和背景体信号抑制进行 DWI，b 值为 1000 s/mm2。计算正常和异常椎体骨髓的表观扩散系数值。
在 16 例患者中发现了 29 个椎体异常。5 例患者的 9 个椎体异常是感染引起的，11 例患者的 20 个椎体异常是退行性改变引起的；7 个节段被分类为 Modic 1 型，7 个节段为 2 型，6 个节段为 3 型。DWI 显示所有感染患者均出现高信号，类似于正电子发射断层扫描（PET），但退行性疾病患者的椎间盘间隙没有这种表现。感染性骨髓的表观扩散系数值明显高于正常和退行性骨髓。
DWI 有助于区分退行性和感染性终板异常。此外，与正电子发射断层扫描（PET）相比，MRI 由于没有电离辐射、成本低且成像时间快，因此在临床上得到广泛应用。因此，DWI 有可能成为一种筛查工具。
