不同程度椎间盘退变相应椎间孔的影像学变化及其临床意义

目的：从影像学角度研究腰椎间盘不同退变程度时相应椎间孔形态改变的规律,探讨其临床意义。方法：自2006年12月至2008年2月选取37例L4,5椎间盘呈退行性变化的影像学资料（MRI、CT）进行研究,男23例,女14例,年龄28～62岁,平均41.6岁;分别将其矢状位MRIT2WI成像,采用MRI机内Mean/Curve测量软件测量计算L4,5节段退变椎间盘信号强度与相应节段脑脊液平均信号强度比值（RSI）,判断椎间盘退变程度并进行分组。分为3组：轻度退变组11例（A组）,中度退变组13例（B组）,重度退变组13例（C组）。根据CT1.25mm薄层二维旁矢状位重建测量L4,5节段椎间孔的最大高度、最大宽度与面积。分析椎间盘在不同退变程度下相应椎间孔变化规律及可能对神经根状态的影响。结果：①中、轻度退变组椎间孔的最大高度及面积差异均无统计学意义（P〉0.05）,重、中度退变组椎间孔最大高度及面积均有统计学意义（P〈0.05）,重、轻度退变组椎间孔最大高度差异有统计学意义（P〈0.01）;②重、中、轻度退变组椎间孔最大宽度差异均无统计学意义（P〉0.05）。结论：随着腰椎间盘退变程度加重相应椎间孔的高度及面积也逐渐减小,而其对椎间孔宽度影响不大;椎间孔高度及面积变小有可能导致神经根受压。

Imageology change of the intervertebral foramen degenerative intervertebral disc in different degrees and its clinical significance

Objective：To study the imageology change of the intervertebral foramen degenerative intervertebral disc in different degrees and explore its clinical significance. Methods：The imageology data （MRI and CT）of 37 patients with degenerative disc disease of L4,5 （male 23,female 14,age from 28 to 62 years with an average of 41.6 years）were investigated. The patients were divided into three groups depending on the mean signal intensity rate of degenerative disc and cerebrospinal fluid：light degenerative group（group A） of 11 cases,intermediate degenerative group （group B） of 13 cases,and severe degenerative group （group C） of 13 cases. The extreme altitude,maximum width and areas of the intervertebral foramen were measured from the CT 1.25 mm scan reconstitution. The changes of the intervertebral foramen were analyzed. Results：①The extreme altitude and areas of the intervertebral foramen gradually diminished among the light degenerative group,intermediate degenerative group and severe degenerative group,there was no significant deviation between intermediate degenerative group and the light degenerative group （P0.05）,there was statistical significance between severe degenerative group and intermediate degenerative group （P0.05）,there was statistical significance between severe degenerative group and light degenerative group （P0.01）. ②There was no statistical significance of the maximum width of intervertebral foramen among three groups （P 0.05）. Conclusion：The extreme altitude and areas of the intervertebral foramen gradually diminished when the disc are differently degenerative. But there was not significant correlation to width of the intervertebral foramen; the dimin height and area of intervertebral foramen should result in root compression.