Bilateral sudden deafness as the first manifestation of Streptococcus Suis Capsular Type 2 meningitis

Abstract

[[abstract]]目的 本研究目的在評估以T2為重之磁振造影影像中，若見到明亮線性面關節訊號是否有意義。方法 回溯性收集25歲以下，曾在民國92年中，因下背痛而接受腰椎磁振造影檢查之案例。共43例接受分析，其中18位男性，25位女性，年齡11到25歲，平均年齡21.4歲。主要觀察腰椎間盤及面關節變化。假如有椎間盤脫水化合併廣泛性膨出或椎間盤疝出，即歸類為疾病組：其餘則歸類為對照組。其次，在以T2為重之影像中，觀察是否有強度類似腦脊髓液且長度等同關節寬度之連續性明亮線狀高訊號（明亮面關節徵象）在面關節內。結果 在疾病組中共有18%有明亮面關節徵象，在對照組中6%有明亮面關節徵象，兩組間具有統計學上之差異性。明亮面關節徵象不僅發生於椎間盤退化之同一脊椎平面之面關節內，亦發生在更上節脊椎平面之而關節內。結論 明亮面關節徵象代表腰椎面關節積水增多，是造成下背痛的原因之一；常併發於腰椎間盤退化疾病。 Purpose. In daily practice, we occasionally see linear bright signals in the lumbar facet joints on T2-weighted MR images. The aim of this study was to evaluate the clinical significance of linear bright signals in facet joints on T2-weighted MR images. Methods. We analyzed all patients younger than 25 years (n=43; 18 males and 25 females; age range, 11 to 25 yr; mean age, 21.4 yr), who had undergone lumbar spinal MRI for lower back pain in 2003. The control group consisted of patients without discogenic disease. The study group comprised patients with discogenic disease. In total, there were 14 patients with 84 facet joints in the control group, and 29 patients with 170 facet joints in the study group. The bright facet sign is defined as a linear signal with intensity similar to that of CSF extending the length of the hyaline cartilage of the facet joint on T2WI. We recorded the difference in the frequency of positive bright facet signs between the control and study groups. Results. Bright facet sign was observed in 5 of the 84 facet joints in the control group (6%) and in 31 of the 170 facet joints in the study group (18%). The difference in the frequency of bright facet sign between these two groups was statistically significant (Student's t test: 3.111, p<0.005; Fisher's exact test: 2.328, p<0.001). The bright facet sign was encountered not only at the same vertebral level of discogenic disease but also at the levels superior to it. The frequency of bright facet sign in the study group was 17 out of 29 patients (59%). Conclusions. Bright facet sign of the lumbar spine on T2 weighted MR images indicates increased joint effusion, which usually results in lower back pain. Bright facet sign is more common in patients with discogenic disease.