MRI 观察腰椎终板 Modic 改变Ⅱ型的病理学变化：脂肪沉积还是骨硬化？
The Pathology of Type II Modic Changes: Fat Deposition or Osteosclerosis? A Study Using CT Scan.
机构信息
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
出版信息
Biomed Res Int. 2018 Jun 4;2018:6853720. doi: 10.1155/2018/6853720. eCollection 2018.
STUDY DESIGN
A retrospective cross-sectional study of type II Modic changes (MCs).
OBJECTIVE
To evaluate the CT values of type II MCs and determine their relationship with disc degeneration.
METHODS
124 type II MCs from 66 patients' MRI and CT were included and analyzed. Disc degeneration adjacent to MCs was evaluated based on Pfirrmann classification. CT values of bone marrow area and endplate from MC regions, adjacent non-MC regions, and L1 vertebra were measured. CT value changes (ΔCT value) were defined as MCs' CT value minus non-MCs'. According to the types of variables, paired t-test, signed-rank test, two-way ANOVA, and Friedman test were used.
RESULTS
The CT value of MCs was significantly higher than that of non-MCs at both bone marrow area and endplate (P<0.0001, resp.). Good consistency was found between non-MCs and L1 vertebra in the CT value of bone marrow area and endplate (P=0.2129, P=0.2272, resp.), suggesting the control group was valid. Adjacent to type II MCs, there were 8 (6.4%) discs with grade III degeneration, 58 (46.8%) with grade IV, and 58 (46.8%) with grade V. The ΔCT value of grade V disc degeneration was larger than that of grade IV at the endplate (P=0.0150).
CONCLUSIONS
Osteosclerosis may exist in type II MCs. The more severe the degeneration of the adjacent disc, the greater the degree of osteosclerosis.
研究设计
II 型 Modic 改变（MC）的回顾性横截面研究。
目的
评估 II 型 MC 的 CT 值并确定其与椎间盘退变的关系。
方法
纳入并分析了 66 例患者 MRI 和 CT 的 124 个 II 型 MC。根据 Pfirrmann 分级评估 MC 相邻椎间盘退变。测量 MC 区域、相邻非 MC 区域和 L1 椎体骨髓区和终板的 CT 值。CT 值变化（ΔCT 值）定义为 MC 的 CT 值减去非 MC 的 CT 值。根据变量类型，采用配对 t 检验、符号秩检验、双向方差分析和 Friedman 检验。
结果
MC 骨髓区和终板的 CT 值明显高于非 MC（P<0.0001，分别）。非 MC 与 L1 椎体骨髓区和终板的 CT 值具有良好的一致性（P=0.2129，P=0.2272，分别），表明对照组有效。在 II 型 MC 相邻的椎间盘中，有 8 个（6.4%）椎间盘退变程度为 III 级，58 个（46.8%）为 IV 级，58 个（46.8%）为 V 级。终板上 V 级椎间盘退变的 ΔCT 值大于 IV 级（P=0.0150）。
结论
II 型 MC 可能存在骨硬化。相邻椎间盘退变越严重，骨硬化程度越大。
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