盘源性腰痛的CT及MRI诊断对照分析

发布时间：2018-04-25 06:38

本文选题：椎间盘源性腰痛 + CT腰椎间盘造影　；参考：《中国CT和MRI杂志》2016年02期

【摘要】：目的比较分析CT腰椎间盘造影及MRI对椎间盘源性腰痛的诊断价值。方法以2014年1月-2015年6月就诊的50例疑似椎间盘源性腰痛患者为研究对象,均行MRI、CT平扫及CT椎间盘造影(CTD)检查,比较MRI与CT椎间盘造影对Modic征、HIZ改变及纤维环破裂分型等诊断结果。结果CT椎间盘造影共80个,CTD分型:I型34个,II型22个,III型14个,IV型10个,其中一致性疼痛共31个(38.7%)。MRI上有纤维环后缘高信号区(HIZ)者15个,无HIZ者64个,HIZ对疼痛预测敏感度、特异度分别为29.0%、87.8%。CTD显示Modic征腰椎间盘共12个,其中一致性疼痛11个,不一致疼痛或不同1例。MRI上IV-V级椎间盘退变32个,其中CTD一致性疼痛26个(81.3%),MRI上IV-V级退变一致性疼痛率明显高于I-III级退变患者(P0.01)。结论CT椎间盘造影对椎间盘源性腰痛纤维环破裂情况可清晰显示,MRI典型影像征象为HIZ、IV-V级椎间盘退变,预测一致性疼痛与CTD分型关系有利于MRI进一步确定责任椎间盘。
[Abstract]:Objective to compare CT and MRI in the diagnosis of discogenic low back pain. Methods 50 patients with suspected discogenic low back pain from January 2014 to June 2015 were studied. MRICT plain scan and CT intervertebral disc angiography (CTD) were performed. To compare the results of MRI and CT discography in the diagnosis of Hiz of Modic sign and rupture of fibrous ring. Results there were 80 CTD types: 34 type I, 22 type II, 22 type III and 14 type IV, among them, there were 31 cases with consistent pain. There were 15 cases with hyperintense area of posterior edge of fibrous ring on MRI, and 64 cases with no HIZ were sensitive to pain prediction. The specificity was 29.0 and 87.8% respectively. CTD showed that there were 12 lumbar intervertebral discs with Modic sign, including 11 consistent pain, inconsistent pain or different IV-V grade disc degeneration in 1 case. The consistent pain rate of IV-V grade on CTD was significantly higher than that of I-III grade degenerative patients (P 0.01). Conclusion CT discography can clearly show that the typical MRI signs of disc degeneration are HIZV grade IV-V disc degeneration. Predicting the relationship between consistent pain and CTD classification is helpful for MRI to further determine the responsible disc.
【作者单位】：广东省英德市人民医院;
【分类号】：R681.53

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