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Modic改变是腰椎间盘退变临近软骨终板区椎体MRI信号改变的一种分类方法。
由Modic MT于1988年在Radiology (Modic MT, Masaryk TJ, and Ross JS, et al. Imaging of degenerative disk disease. Radiology, 1988; 168:177~186 )首次提出，共分为I、II、III型。
I型:T1加权像该区信号降低,T2加权像该区信号升高,T1加权强化像该区信号升高,软骨终板断裂或者撕裂，以及邻近松质骨髓腔内的再血管化纤维组织形成为该区软骨下血管化的纤维组织以及与此相关的软骨终板的裂隙或破裂，提示软骨终板处于炎症期或者水肿期，俗称为终板炎；
II型II型为脂肪期或者黄骨髓期:T1加权像该区信号增强,T2加权像则表现为等信号或轻度增强信号,梯度回波(T2*)为等信号强度,病理学为该区脂肪组织替代正常的软骨或骨组织,终板区破裂及其继发性炎性反应；
III型为骨质硬化期， T1WI及T2WI均为低信号。相应的X线表现为该区广泛骨硬化；
Above an MRI of the lower spine showing the central cut. The disc between the sacrum and the fifth lumbar vertebra is dried out with a black appearance and decreased height. The white changes in the bone reflect a reaction to the degeneration, described by Modic and named after him as Modic changes. The disc above has a completely normal appearance. This is classified as discopathy L5/S1.
Modic changes, a common observation in MR imaging, are signal intensity changes in vertebral body marrow adjacent to the endplates of degenerative discs.
Michael T. Modic, MD, professor of radiology and neurology at Case Western in Cleveland, wrote about these changes in the journal Radiology in 1988, and his name has been associated with these changes ever since.
Modic changes take 3 main forms:
Type I
Decreased signal on T1, and increased signal on T2.
Represents marrow edema.
Associated with an acute process.
Histological examination shows disruption and fissuring of the endplate and vascularized fibrous tissues within the adjacent marrow
Type II - the most common type
Increased signal on T1, and isointense or slightly hyperintense signal on T2.
Represents fatty degeneration of subchondral marrow.
Associated with a chronic process.
Histological examination shows endplate disruption with yellow marrow replacement in the adjacent vertebral body.
Type I changes convert to Type II changes with time, while Type II changes seem to remain stable.
Type III
Decreased signal on both T1 and T2.
Correlate with extensive bony sclerosis on plain radiographs.
Histological examination shows dense woven bone; hence, no marrow to produce MRI signal.
MODIC CHANGES on MRI
T1 T2 特征
TYPE 1
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水肿
TYPE II
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(or slight )
脂肪退变
TYPE III ¯
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骨硬化 |
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发表于 2012-11-11 14:49
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