Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria.
Department of Neurology, Medical University of Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2020 Jan;132(1-2):27-34. doi: 10.1007/s00508-019-01576-x. Epub 2019 Nov 26.
On magnetic resonance imaging (MRI), posterior lumbar subcutaneous edema (PLSE) is a frequent incidental, yet unclear finding within the deep subcutaneous perifascial tissue. This study aimed to investigate PLSE in various pathological lumbar conditions.
This retrospective study included the MR images of the lumbar spine of 279 patients (age range 18-82 years) without cardiovascular, renal or hepatic diseases, 79 of whom had low-grade disc degeneration, 101 combined endplate and facet joint degeneration, 53 axial spondyloarthritis and 46 infectious spondylodiscitis. There were 232 patients with a body mass index (BMI) <30, and 47 with a BMI ≥30 (obese). For each group, the relationship between PLSE and BMI was analyzed using multiple logistic regression, and between PLSE extension and BMI using ordinal regression.
A PLSE was found in 11/79 (13.9%) patients with disc degeneration, 37/101 (36.6%) with endplate and facet joint degeneration, 7/53 (13.2%) with spondyloarthritis, and 28/46 (60.9%) with spondylodiscitis. For each group, a statistically significant relationship was demonstrated between PLSE and BMI (P = 0.000-P = 0.031), except for spondylodiscitis (P = 0.054), as well as between PLSE extension and BMI (P = 0.000-P = 0.049). A PLSE was found in 21.1% of nonobese and 72.3% of obese patients (P = 0.000).
The presence of PLSE seems to be associated with various lumbar conditions, particularly in obese patients. Its perifascial location may suggest a potential fascial origin; however, PLSE should not to be confused with posttraumatic, postsurgical or infectious edema or edema associated with internal diseases.
磁共振成像（MRI）中，腰椎皮下深部筋膜周围组织内出现的后腰椎皮下水肿（PLSE）是一种常见的偶发但不明原因的表现。本研究旨在探讨不同腰椎病变中的 PLSE。
本回顾性研究纳入了 279 例无心血管、肾脏或肝脏疾病的腰椎 MRI 图像，年龄在 18-82 岁之间，其中 79 例为低等级椎间盘退变，101 例为终板和小关节退变，53 例为轴性脊柱关节炎，46 例为感染性脊柱骨髓炎。232 例患者 BMI＜30，47 例 BMI≥30（肥胖）。对于每组患者，使用多变量逻辑回归分析 PLSE 与 BMI 的关系，使用有序回归分析 PLSE 扩展与 BMI 的关系。
在椎间盘退变患者中，11/79（13.9%）、终板和小关节退变患者中 37/101（36.6%）、脊柱关节炎患者中 7/53（13.2%）和脊柱骨髓炎患者中 28/46（60.9%）发现有 PLSE。对于每组患者，PLSE 与 BMI 之间存在显著的相关性（P=0.000-P=0.031），但脊柱骨髓炎组除外（P=0.054），PLSE 扩展与 BMI 之间也存在显著的相关性（P=0.000-P=0.049）。非肥胖患者的 PLSE 发生率为 21.1%，肥胖患者为 72.3%（P=0.000）。
PLSE 的存在似乎与各种腰椎病变有关，尤其是肥胖患者。其筋膜周围位置可能提示潜在的筋膜起源；但是，PLSE 不应与创伤后、手术后或感染性水肿或与内部疾病相关的水肿混淆。
