中重度腰骶部硬膜外脂肪增多与临床腰腿痛症状相关性的MRI研究

发布时间：2018-06-20 09:04

本文选题：硬膜外脂肪增多症 + 磁共振成像　；参考：《临床放射学杂志》2015年04期

【摘要】：目的探讨中重度腰骶部硬膜外脂肪增多的发生率及其与临床腰腿痛症状的相关性。方法回顾性分析6921例腰骶椎MRI影像,根据腰骶部硬膜外脂肪分级标准,将中重度硬膜外脂肪增多者列为研究对象,统计其发生率、与性别和年龄的关系。另外,按有无腰腿痛症状将患者分为有症状组和无症状组,研究中重度硬膜外脂肪增多与腰腿痛症状的相关性。结果 6921例中,中重度腰骶部硬膜外脂肪增多患者发生率为2.76%,其中男性和女性发生率分别为3.84%和1.79%,男性发生率明显高于女性;各年龄组间中重度腰骶部硬膜外脂肪增多发生率无统计学意义。症状组中重度硬膜外脂肪增多发生率2.21%,无症状组5.93%,症状组发生率低于无症状组。症状组中96.15%的病例有明确的腰骶部骨和/或椎间盘异常,包括椎间盘病变或退变者70.77%,椎管狭窄37.69%,小关节病变29.23%,黄韧带肥厚23.84%,退变或峡部不连椎体滑移9.23%和椎体终板炎8.46%。中重度腰骶部硬膜外脂肪增多硬膜囊末端位置多位于腰5、骶1水平,症状组与无症状组间无明显统计学差异。结论腰骶部中重度硬膜外脂肪增多在腰腿痛患者及无症状人群中较常见,尤其在男性患者中具有较高的发生率。该现象与年龄和临床腰腿痛症状无明确相关性。只有在MRI横断位显示硬膜囊变形,而患者缺乏其他影像学异常能够解释临床腰腿疼症状时,腰骶部硬膜外脂肪增多现象才需要考虑硬膜外脂肪增多症的可能性。
[Abstract]:Objective to investigate the incidence of moderate and severe epidural fat increase in lumbosacral region and its correlation with the clinical symptoms of lumbago and leg pain. Methods 6921 cases of lumbosacral vertebrae were retrospectively analyzed. According to the classification standard of lumbosacral epidural fat, moderate and severe epidural fat was selected as the study object, and the incidence rate, sex and age were analyzed. In addition, the patients were divided into symptomatic group and asymptomatic group according to the symptoms of low back leg pain. Results the incidence of moderate and severe lumbosacral epidural fat increase was 2.76% in 6921 cases. The incidence of male and female were 3.84% and 1.79 respectively. The incidence of male was significantly higher than that of female. The incidence of moderate and severe epidural fat increase in all age groups was not statistically significant. The incidence of moderate and severe epidural fat increase was 2.21 in the symptom group, 5.93 in the asymptomatic group, and lower in the symptom group than in the asymptomatic group. In the symptom group, 96.15% of the cases had definite lumbosacral bone and / or disc abnormalities, including 70.77 cases with disc lesion or degeneration, 37.69 99.69 cm with spinal canal stenosis, 29.23% with small articular lesion, 23.84% with hypertrophy of ligamentum flavum, 9.23% with degeneration or spondylolysis without spondylolysis and 8.46 6 with vertebral endplate inflammation. The end position of epidural fat increased dural sac in middle and severe lumbosacral region was mostly located at the level of lumbar 5 and sacral 1. There was no significant difference between symptom group and asymptomatic group. Conclusion increased epidural fat in lumbosacral region is more common in patients with lumbago and leg pain and asymptomatic population, especially in male patients. This phenomenon has no clear correlation with age and clinical symptoms of low back and leg pain. The possibility of epidural lipomatosis should be considered only when the deformity of dural sac is shown in the transverse position of MRI and the absence of other imaging abnormalities can explain the clinical symptoms of lumbar and leg pain.
【作者单位】：浙江大学附属邵逸夫医院放射科;诸暨市人民医院放射科;浙江奉化市人民医院;
【分类号】：R681.5;R445.2

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