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目的探究MRI在氟骨症脊柱病变中的诊断价值。方法收集本院2011年5月至2015年4月收治的78例氟骨症脊柱病变患者脊柱MRI资料,并与X线对比,并通过配对法收集本院收治的未患有氟骨症的96例颈椎MRI做为对照组,对比分析两组MRI结果。结果所有椎体信号在T1WI、T2WI上均显示为不均匀或均匀性降低,氟骨症组患者C3~7椎体信号强度均低于对照组,两组差异有统计学意义(P<0.05);MRI显示黄韧带与后纵韧带骨化68例(87.18%),与X线平片相似,其中7例(8.97%)黄韧带骨化(均于胸椎内),34例(43.59%)后纵韧带骨化,27例(34.62%)黄韧带与后纵韧带骨化。61例骨化后纵韧带在T1WI上有30例(49.18%)显示为中等信号强度,34例骨化黄韧带在T1WI上有30例(88.24%)显示为中等信号。78例氟骨症患者中72例(92.31%)椎管狭窄,脊髓受压60例(76.92%);椎间盘突出65例(83.33%);椎间盘变性54例(69.23%)。56例颈椎MRI表现出47例(83.93%)脊髓受压,而X线平片判定脊髓受压39例(69.64%)。氟骨症组患者椎间盘突出及变性例数均高于对照组,两组差异有统计学意义(P<0.05)。结论 MRI显示氟骨症椎体信号强度表现为均匀或不均匀性降低,可直接反映骨髓内脂肪分布、含量及成骨活动增强程度。MRI可准确显示出椎间盘突出、变性、脊髓内病理学变化及脊柱受压情况,在氟骨症脊柱病变诊断中具有重要意义。
Objective To investigate the diagnostic value of MRI in skeletal fluorosis. Methods The MRI data of 78 patients with skeletal fluorosis spondylosis from May 2011 to April 2015 in our hospital were collected and compared with X-ray. The data of 96 patients without fluorosis Cases of cervical MRI as a control group, comparative analysis of two MRI results. Results All vertebral body signals showed nonuniformity or even reduction on T1WI and T2WI. The signal intensity of C3-7 vertebral body in fluorosis group was lower than that in control group (P <0.05) ; MRI showed ossification of the ligamentum flavum and posterior longitudinal ligament in 68 cases (87.18%), which were similar to X-ray plain radiographs. Among them, 7 cases (8.97%) had ossification of the ligamentum flavum Longitudinal ligament ossification, 27 cases (34.62%) yellow ligament and posterior longitudinal ligament ossification. Thirty (49.18%) of the 61 patients with ossification of the posterior longitudinal ligament showed moderate signal intensity on the T1WI and 30 (88.24%) of the 34 ossified ligamentum flavum showed moderate signal on the T1WI. Among 78 patients with skeletal fluorosis, 72 (92.31%) had spinal stenosis, 60 (76.92%) had spinal compression, 65 (83.33%) had disc herniation and 54 (69.23%) had disc degeneration. Fifty-seven cases (83.93%) of the cervical spondylosis showed compression of the spinal cord, while 39 cases (69.64%) of the spinal cord compression were determined by X-ray. The number of disc herniation and degeneration in patients with skeletal fluorosis was higher than that of the control group, with significant difference between the two groups (P <0.05). Conclusion MRI shows that the signal strength of fluorosis vertebral body is uniform or inhomogeneous, which can directly reflect the distribution and content of fat in bone marrow and the degree of enhancement of osteogenic activity. MRI can accurately show the disc herniation, degeneration, intraspinal pathological changes and spinal compression, in the diagnosis of skeletal fluorosis is important.