摘要
目的探讨腰椎Modic改变的类型、位置、范围与腰痛椎间盘退变分级之间的相关性。方法多中心前瞻性研究中搜集腰痛患者并进行腰椎MRI扫描、VAS评分及椎间盘退变分级,统计各型Modic改变在腰椎各节段的发病率及分布情况,测量Modic改变最大垂直累及高度及水平长度。使用ImageJ勾画Modic改变面积并计算Modic改变相对面积,分析Modic改变的位置及范围与VAS及椎间盘退变分级间的相关性。结果Modic改变相对面积与椎间盘退变分级呈轻度正相关(r=0.304,P<0.001),Modic改变相对高度及相对长度与椎间盘退变分级呈弱正相关(r分别为0.122、0.264,P均<0.05);Modic改变Ⅰ型水平长度评分及相对高度与VAS评分呈轻度正相关(r分别为0.342、0.301,P均<0.05),但Modic改变Ⅱ型相对高度及Modic改变Ⅱ型水平长度评分与VAS评分无明显相关性。Modic改变Ⅰ型发病率稍高于Modic改变Ⅱ型(Modic改变Ⅰ型:51.07%,Modic改变Ⅱ型:48.93%),在较低的腰椎节段Modic改变患病率更高(L 5~S 1:47.86%,L 4~L 5:31.82%);在水平位置上,Modic改变累及到前中后部最多,其次为前中部。结论Modic改变面积与椎间盘退变呈正相关;Modic改变Ⅰ型范围与腰痛呈正相关,但Modic改变Ⅱ型与腰痛无明显相关性。
Objective To explore the correlation between the type,location,and range of lumbar Modic changes with the low back pain and grade of intervertebral disc degeneration.Methods In this multicenter prospective study,patients with low back pain were collected and underwent MRI scans,VAS score,and disc degeneration grade.The incidence and distribution of Modic changes in each lumbar segment were counted.The maximum vertical involvement height and horizontal length of Modic changes were measured.ImageJ was used to delineate Modic changes area and calculate Modic changes relative area.The correlation between Modic changes location and range with VAS score and disc degeneration grade was analyzed.Results The relative area of Modic changes was slightly positive correlated with the grade of intervertebral disc degeneration(r=0.304,P<0.001),and the relative height and relative length of Modic changes were weak positive correlated with the grade of intervertebral disc degeneration(r=0.122,0.264,P<0.001,respectively).Modic changes TypeⅠhorizontal length score and relative height were slightly positive correlated with VAS score(r=0.342 and 0.301,respectively,P<0.05).But Modic changes TypeⅡrelative height and horizontal length score were not significantly correlated with VAS score.The incidence of Modic changes TypeⅠwas slightly higher than that of Modic changes TypeⅡ(Modic changes TypeⅠ:51.07%,Modic changes TypeⅡ:48.93%),and the incidence of Modic changes was higher at the lower lumbar segments(L 5-S 1:47.86%,L 4-L 5:31.82%).In horizontal position,Modic changes were most frequently involved in the whole vertebral,followed by the anterior-middle.Conclusion The area of Modic changes was positive correlated with intervertebral disc degeneration,the range of Modic changes TypeⅠwas positive correlated with low back pain,but there was no significant correlation between Modic changes TypeⅡand low back pain.
作者
严俊
黄益龙
柳晓龙
李文智
蒋超梅
何登飞
范广涛
周顺繁
何波
YAN Jun;HUANG Yilong;LIU Xiaolong(Medical Imaging Center of Qujing First People's Hospital,Qujing,Yunnan Province 655000,P.R.China)
出处
《临床放射学杂志》
北大核心
2025年第1期150-154,共5页
Journal of Clinical Radiology
基金
曲靖市第一人民医院重点项目(编号:2022YJKTZ05)。
关键词
腰痛
Modic改变椎间盘退变
磁共振成像
Low back pain
Modicchanges Intervertebral disc degeneration
Magnetic resonance imaging
