Stäbler A, Weiss M, Scheidler J, Krödel A, Seiderer M, Reiser M
Department of Diagnostic Radiology, Klinikum Grosshadern, Munich, Germany.
Skeletal Radiol. 1996 Feb;25(2):119-26. doi: 10.1007/s002560050047.
This prospective study was designed to determine the MRI features, clinical significance, and correlation to histopathologic findings of secondary vascularized degenerative intervertebral disks.
Fifty-three patients with localized painful spine syndrome were investigated prospectively by contrast-enhanced MRI. Pain was not predominantly radiating and there was no clinical evidence of spinal infection. In all patients sagittal SE T1-weighted, fast SE T2-weighted or turbo-STIR, and T1-weighted frequency-selective fat-suppressed images were obtained.
We identified 37 vascularized disks in 26 patients. In 18 patients the changes had occurred spontaneously, in 6, the affected disk had been operated on previously, and 2 patients had spondylolisthesis. In 15 patients, vascularization was accompanied by medullary edema adjacent to the vertebral endplates. In one of the vascularized disks, herniation was also found. In seven patients, ventral diskectomy was performed. Histopathologic findings confirmed disk vascularization in six of seven cases.
Degenerative, band-like disk vascularization is a feature which is associated with local pain. It was demonstrated by contrast-enhanced MRI. Degenerative disk vascularization is an important differential diagnosis to bacterial spondylodiskitis. It can be a cause of pain in patients with postdiskectomy syndrome.
本前瞻性研究旨在确定继发性血管化退变椎间盘的MRI特征、临床意义及其与组织病理学发现的相关性。
对53例局限性脊柱疼痛综合征患者进行前瞻性对比增强MRI检查。疼痛并非主要为放射性，且无脊柱感染的临床证据。所有患者均获得矢状面SE T1加权、快速SE T2加权或涡轮自旋回波脂肪抑制（turbo-STIR）以及T1加权频率选择脂肪抑制图像。
我们在26例患者中发现了37个血管化椎间盘。18例患者的变化为自发出现，6例患者的受累椎间盘曾接受过手术，2例患者有椎体滑脱。15例患者的血管化伴有邻近椎体终板的骨髓水肿。在其中一个血管化椎间盘中还发现了椎间盘突出。7例患者接受了前路椎间盘切除术。组织病理学结果在7例中的6例证实了椎间盘血管化。
退行性、带状椎间盘血管化是与局部疼痛相关的一个特征。通过对比增强MRI得以证实。退行性椎间盘血管化是细菌性椎间盘炎的重要鉴别诊断。它可能是椎间盘切除术后综合征患者疼痛的一个原因。
