小关节液增多可预测腰椎管狭窄症患者轴向负荷MRI上硬脊膜囊大小的动态变化。
Increased Facet Fluid Predicts Dynamic Changes in the Dural Sac Size on Axial-Loaded MRI in Patients with Lumbar Spinal Canal Stenosis.
作者信息
Kanno H, Ozawa H, Koizumi Y, Morozumi N, Aizawa T, Itoi E
机构信息
From the Department of Orthopedic Surgery (H.K., H.O., T.A., E.I.), Tohoku University School of Medicine, Sendai, Japan
From the Department of Orthopedic Surgery (H.K., H.O., T.A., E.I.), Tohoku University School of Medicine, Sendai, Japan.
出版信息
AJNR Am J Neuroradiol. 2016 Apr;37(4):730-5. doi: 10.3174/ajnr.A4582. Epub 2015 Nov 12.
BACKGROUND AND PURPOSE
Axial-loaded MR imaging, which simulates the spinal canal in a standing position, demonstrates reductions of the dural sac cross-sectional area in patients with lumbar spinal canal stenosis. However, there has been no useful conventional MR imaging finding for predicting a reduction in the dural sac cross-sectional area on axial-loaded MR imaging. Previous studies have shown that increased facet fluid is associated with the spinal instability detected during positional changes. The purpose of this study was to analyze the correlations between facet fluid and dynamic changes in the dural sac cross-sectional area on axial-loaded MR imaging.
MATERIALS AND METHODS
In 93 patients with lumbar spinal canal stenosis, the dural sac cross-sectional area was measured by using axial images of conventional and axial-loaded MR imaging. Changes in the dural sac cross-sectional area induced by axial loading were calculated. The correlation between the facet fluid width measured on conventional MR imaging and the change in dural sac cross-sectional area was analyzed. The change in the dural sac cross-sectional area was compared between the intervertebral levels with and without the facet fluid width that was over the cutoff value determined in this study.
RESULTS
The dural sac cross-sectional area was significantly smaller on axial-loaded MR imaging than on conventional MR imaging. The facet fluid width significantly correlated with the change in the dural sac cross-sectional area (r = 0.73, P < .001). The change in the dural sac cross-sectional area at the intervertebral level with the facet fluid width over the cutoff value was significantly greater than that at the other level.
CONCLUSIONS
The increased facet fluid on conventional MR imaging is highly predictive of the dynamic reduction of dural sac cross-sectional area detected on axial-loaded MR imaging in the clinical assessment of lumbar spinal canal stenosis.
背景与目的
轴向负荷磁共振成像模拟站立位时的椎管情况，显示腰椎管狭窄患者硬脊膜囊横截面积减小。然而，尚无有用的传统磁共振成像表现可用于预测轴向负荷磁共振成像时硬脊膜囊横截面积的减小。既往研究表明，小关节液增多与体位改变时检测到的脊柱不稳定相关。本研究的目的是分析小关节液与轴向负荷磁共振成像时硬脊膜囊横截面积动态变化之间的相关性。
材料与方法
对93例腰椎管狭窄患者，利用传统磁共振成像和轴向负荷磁共振成像的轴位图像测量硬脊膜囊横截面积。计算轴向负荷引起的硬脊膜囊横截面积变化。分析传统磁共振成像测量的小关节液宽度与硬脊膜囊横截面积变化之间的相关性。比较存在和不存在本研究确定的临界值以上小关节液宽度的椎间水平之间硬脊膜囊横截面积的变化。
结果
轴向负荷磁共振成像时硬脊膜囊横截面积显著小于传统磁共振成像时。小关节液宽度与硬脊膜囊横截面积变化显著相关（r = 0.73，P <.001）。小关节液宽度超过临界值的椎间水平处硬脊膜囊横截面积的变化显著大于其他水平处。
结论
在腰椎管狭窄的临床评估中，传统磁共振成像上小关节液增多高度提示轴向负荷磁共振成像检测到的硬脊膜囊横截面积动态减小。
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