Maruyama Y
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1995 Nov;69(11):1102-12.
A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. The findings were compared with those of the lumbar spine that had previously been reported by Yasuma et al. on 1238 lumbar discs from 197 cadavers ranging in age from 11 to 92 years. The results were as follows: 1) Low intensity in the T2-weighted MRI was well correlated with histological degeneration in the cervical disc disc. 2) The rate of appearance of the posterior protrusion of the cervical disc on the MRI was in accordance with the degree of histological disc degeneration, but it did not always correspond with histological posterior protrusion. There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. 3) In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. 4) There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines.
从36具尸体的尸检中获取了总共210个颈椎间盘,并对其进行了磁共振成像(MRI)和椎间盘造影,以比较它们在研究颈椎退变方面的诊断效能。受试者年龄在43岁至92岁之间,平均年龄为68.1岁。尸检后,对切除的颈椎柱进行MRI和椎间盘造影,然后将标本准备用于组织学检查。将这些结果与Yasuma等人先前报道的197具年龄在11岁至92岁之间尸体的1238个腰椎间盘的结果进行比较。结果如下:1)T2加权MRI中的低信号与颈椎间盘的组织学退变密切相关。2)颈椎间盘在MRI上后凸的出现率与椎间盘组织学退变程度一致,但并不总是与组织学后凸相对应。MRI上假阳性后凸的发生率非常高,在解读MRI时应牢记这一点。3)在MRI与椎间盘造影的比较中,发现两者在椎间盘退变方面存在一定的正相关,但并不完全一致。4)颈椎和腰椎间盘的退变模式和后凸情况存在相当大的差异。颈椎间盘的后凸更可能与后纵韧带的水平裂隙和玻璃样变有关,而腰椎间盘的后凸常与后纵韧带束的反向排列和黏液样变性有关。这种差异归因于颈椎和腰椎力学特性的不同。