摘要
目的探讨磁共振成像（MRI）特征和病理改变反映腰椎间盘退行性变的一致性。方法选择2013年9月至2014年9月在新乡医学院第一附属医院骨科一病区行手术治疗的腰椎间盘突出症患者30例为观察组,选择同期非手术治疗腰椎间盘突出症的腰腿痛年轻患者20例为对照组,50例患者均行腰椎间盘MRI平均信号强度测定。手术患者术中取髓核标本,术后测定水分含量,显微镜下观察和计数软骨样细胞,统计分析腰椎间盘突出髓核MRI平均信号强度和髓核水分含量之间的相关性,检验MRI和病理学反映腰椎间盘退行性变的一致性;测量腰椎间盘突出症患者椎间隙高度,评估腰椎间盘突出程度。结果对照组患者MRI平均信号强度明显高于观察组（P〈0.01）;观察组患者Ⅱ类椎间盘的MRI平均信号强度、水含量明显高于Ⅲ类椎间盘（P〈0.01）;观察组患者Ⅱ、Ⅲ类椎间盘的MRI平均信号强度和水含量均存在正相关（r=0.989、0.979,P〈0.01）;观察组患者Ⅱ类椎间盘的软骨样细胞数明显高于Ⅲ类椎间盘（P〈0.01）;MRI和病理学反映腰椎间盘退行性变的K值为0.74,K值在0.40~0.75,表示MRI和病理学反映腰椎间盘退行性变存在显著一致性;对照组患者腰4-5和腰5骶1的前高、后高、平均高度、前后高比均高于观察组（P〈0.01）。结论 MRI和病理学反映腰椎间盘退行性变具有显著一致性,为临床上认识腰椎间盘突出症的自然病史,及早做出正确的临床诊断和治疗,准确判断疾病预后提供了理论依据。
Objective To investigate the consistency of magnetic resonance imaging（ MRI） and pathological changes in reflecting lumbar intervertebral disc degeneration. Methods Thirty patiens with lumbar intervertebral disc degeneration who were given operative treatment in Orthopedics Department of the First Affiliated Hospital of Xinxiang Medical University from September 2013 to September 2014,were selected as observation group. Twenty patients with lumbar intervertebral disc degeneration who did not undergo operative treatment but with pain in waist and lower extremities were selected as control group. The average signal intensity of MRI for lumbar intervertebral disc was measured in the 50 patients. Nucleus pulposus specimens of surgery patients were collected during operation,water content of nucleus pulposus was analyzed after operation,chondroid cells were observed and counted under a microscope,the correlation between average signal intensity and water content nucleus pulposus with lumbar intervertebral disc herniation was statistical analyzed,the consistency of MRI and pathology changes of lumbar intervertebral disc degeneration was inspected. The degree of lumbar intervertebral disc herniation was evaluated by height measurement. Results The average signal intensity of control group was significantly higher than that of observation group（P 0. 01）. Average signal intensity and water content of type Ⅱ intervertebral disc in observation group were significantly higher than those of type Ⅲ intervertebral disc（ P 0. 01）. Average signal intensity of type Ⅱ and type Ⅲ intervertebral disc in observation group was positively correlated with water content（ r = 0. 989,0. 979,P 0. 01）. Chondroid cells of type Ⅱintervertebral disc in observation group was significantly higher than type Ⅲ intervertebral disc（ P 0. 01）. K value of MRI and pathology which could reflect the lumbar intervertebral disc degeneration was 0. 74,K values were 0. 40- 0. 75,which illustrated that there was significant consi
出处
《新乡医学院学报》
CAS
2015年第4期314-317,共4页
Journal of Xinxiang Medical University
基金
国家自然科学基金资助项目(编号:81072552)
河南省科技创新杰出青年基金资助项目(编号:104100510016)
关键词
腰椎间盘突出症
腰椎间盘退行性变
磁共振成像
病理学
一致
lumbar intervertebral disc herniation
lumbar intervertebral disc degeneration
magnetic resonance imaging
pathology
consistency
