Abstract
目的 评价MRI在地方性氟骨症脊柱病变诊断中的作用.方法对81例地方性氟骨症的脊柱MRI进行分析和与X线比较.结果所有椎体内脂肪含量减少和分布不均,在T1WI上信号强度表现为均匀或不均匀性减低,其信号减低程度与X线骨密度的增高程度相比较无明确相关性.32例C3～7椎体的T1WI信号强度平均值明显低于100例对照组(P<0.001).81例中后纵韧带和黄韧带骨化71例(88%),其中后纵韧带骨化35例(43%),黄韧带骨化8例(10%),后纵韧带和黄韧带骨化28例(35%),与X平片所显示的相同.在T1WI上63例后纵韧带骨化和36例黄韧带骨化有中等信号强度区者分别为32例(51%)和31例(86%).81例中椎间盘突出68例(84%),椎间盘变性57例(70%),椎管狭窄75例(92%),脊髓受压63例(78%),其中脊髓内有病理学改变28例(35%).X线测量57例颈椎椎管前后径<9 mm(以此推断脊髓受压)41例(71.92%),MRI显示脊髓受压48例(84.21%,P=0.115).57例颈椎椎间盘后突出51例(89.47%),明显高于对照组(62%)(P<0.001);椎间盘变性37例(64.91%),与对照组(37%)相比较差异有非常显著性意义(P=0.001).结论 MRI显示地方性氟骨症的椎体信号强度均匀或不均匀性减低,可反应成骨活动增强程度和氟化钙及骨髓内脂肪含量及分布.MRI对显示脊髓受压,脊髓内病理学改变和椎间盘突出、变性优于X线。
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