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目的探讨经典型舒尔曼病的MRI表现特征及临床意义。方法回顾性分析2014年8月至2016年2月26例经典型舒尔曼病的MRI及临床资料。结果所有患者均以胸背部疼痛就诊,出现症状至MRI检查时间为2周~1年,平均(3±0.2)个月;均伴中胸段脊柱轻度后凸畸形及椎体楔形变,楔形变椎体主要累及T5~T7椎体,其中单个椎体受累及16例,累及2个椎体6例,累及3个椎体4例;均伴多个胸椎椎体终板局部不规则或局限性缺损及Schmorl结节,终板异常及Schmorl结节,主要位于T5~T12椎体,累及椎体个数5~8(6.5±1.2)个,2例伴Ⅰ型终板炎,胸椎Schmorl结节数量7~15(11±0.8)个;19例伴前纵韧带肥厚,伴椎间盘膨出或突出8例,伴黄韧带肥厚18例,伴椎体血管瘤1例。结论认识经典型舒尔曼病的临床及MRI表现特征有助于诊断及鉴别诊断。
Objective To investigate the MRI features and clinical significance of classical Schulman’s disease. Methods The MRI and clinical data of 26 classic cases of Schulman’s disease from August 2014 to February 2016 were retrospectively analyzed. Results All patients were treated with chest and back pain. The time from symptom to MRI examination was 2 weeks to 1 year with an average of (3 ± 0.2) months. All patients had moderate and severe thoracic spine kyphosis, Variable vertebral body mainly involving the T5 ~ T7 vertebral body, including a single vertebral involvement and 16 cases, involving 2 vertebral body in 6 cases, involving 3 vertebral body in 4 cases; both with multiple thoracic vertebral endplates local irregular or limited Schurtz nodules, end-plate abnormalities and Schmorl nodules were mainly located in the T5-T12 vertebra, involving 5 ~ 8 (6.5 ± 1.2) vertebral bodies, 2 cases with type Ⅰ endostitis, Schmorl knot The number of segments ranged from 7 to 15 (11 ± 0.8). There were 19 cases with anterior longitudinal ligament hypertrophy, 8 cases with disc herniation or protrusion, 18 cases with ligamentum flavum hypertrophy and 1 case with vertebral hemangiomas. Conclusion It is helpful to diagnose and differentiate the clinical and MRI features of classical Schulman disease.