目的:这项研究的目的是检查T1和T2加权矢状磁共振(MR)图像上的高强度区(HIZ)特征,并揭示它们的确切性质。
方法:纳入73例腰背痛和HIZs患者(在T2加权图像上确定)。患者,年龄25-80岁(平均51岁),分为两组:“单HIZ”组仅在T2加权图像上显示HIZ,而“双HIZ”组在T2加权和T1加权图像上都显示出HIZ。从手术中收获对应于HIZ的组织用于分析。
结果:研究了82个圆盘,从39名患者的单一的HIZs,30个带双HIZ,四个都在后环。HIZ卷,体积比,来自双HIZ组的T2加权图像上的信号强度明显更大。手术能够成功恢复两组患者的能力,而保守治疗对双重HiZs患者效果较差。组织学显示,单HIZ组的肉芽组织侵入了外部环状裂隙。在双HIZ光盘中,VonKossa染色和CT扫描显示更多钙化或骨化病变(94.1vs.0%,P<0.001),和化学分析显示钙含量明显较高。
结论:T2和T1加权图像上的HIZ代表钙化组织,可能来自椎骨终板。应该定义双重HIZ的新概念。
结论:•HIZ的常规定义仅指T2加权图像。•双HIZ具有更大的HIZ音量,体积比,和信号强度。•T2和T1加权图像上的HIZ表示钙化组织。•保守治疗不太可能有效的患者与双his。
OBJECTIVE: The aim of this study was to examine high-intensity zone (HIZ) characteristics on both T1- and T2-weighted sagittal magnetic resonance (MR) images, and to reveal their exact nature.
METHODS: Seventy-three patients with low back pain and HIZs (identified on T2-weighted images) were included. Patients, aged 25-80 years (mean 51), were divided into two groups: the \'single-HIZ\' group exhibited HIZs only on T2-weighted images, while the \'dual-HIZ\' group exhibited HIZs on both T2-weighted and T1-weighted images. Tissue corresponding to the HIZ was harvested from surgery for analysis.
RESULTS: Eighty-two discs were studied, from 39 patients with single HIZs, 30 with dual HIZs, and four with both in the posterior annulus. HIZ volume, volume ratio, and signal intensity on T2-weighted images from the dual-HIZ group were significantly greater. Surgery was able to successfully restore patients\' ability in both groups, while conservative treatments were less effective for patients with dual HIZs. Histology revealed outer annular fissures invaded by granulation tissue in the single-HIZ group. In dual-HIZ discs, Von Kossa staining and CT scans showed more calcified or ossified lesions (94.1 vs. 0 %, P<0.001), and chemical analysis showed significantly higher calcium content.
CONCLUSIONS: HIZs on both T2- and T1-weighted images represent calcified tissue, possibly from a vertebral endplate. A new concept of dual HIZ should be defined.
CONCLUSIONS: • Conventional definition of an HIZ refers to T2-weighted images only. • Dual HIZs have greater HIZ volume, volume ratio, and signal intensity. • HIZs on both T2- and T1-weighted images represent calcified tissue. • Conservative treatments are less likely to be effective for patients with dual HIZs.