發(fā)布時(shí)間：2018-04-25 06:38

  本文選題：椎間盤源性腰痛 + CT腰椎間盤造影　； 參考：《中國(guó)CT和MRI雜志》2016年02期

【摘要】：目的比較分析CT腰椎間盤造影及MRI對(duì)椎間盤源性腰痛的診斷價(jià)值。方法以2014年1月-2015年6月就診的50例疑似椎間盤源性腰痛患者為研究對(duì)象,均行MRI、CT平掃及CT椎間盤造影(CTD)檢查,比較MRI與CT椎間盤造影對(duì)Modic征、HIZ改變及纖維環(huán)破裂分型等診斷結(jié)果。結(jié)果CT椎間盤造影共80個(gè),CTD分型:I型34個(gè),II型22個(gè),III型14個(gè),IV型10個(gè),其中一致性疼痛共31個(gè)(38.7%)。MRI上有纖維環(huán)后緣高信號(hào)區(qū)(HIZ)者15個(gè),無(wú)HIZ者64個(gè),HIZ對(duì)疼痛預(yù)測(cè)敏感度、特異度分別為29.0%、87.8%。CTD顯示Modic征腰椎間盤共12個(gè),其中一致性疼痛11個(gè),不一致疼痛或不同1例。MRI上IV-V級(jí)椎間盤退變32個(gè),其中CTD一致性疼痛26個(gè)(81.3%),MRI上IV-V級(jí)退變一致性疼痛率明顯高于I-III級(jí)退變患者(P0.01)。結(jié)論CT椎間盤造影對(duì)椎間盤源性腰痛纖維環(huán)破裂情況可清晰顯示,MRI典型影像征象為HIZ、IV-V級(jí)椎間盤退變,預(yù)測(cè)一致性疼痛與CTD分型關(guān)系有利于MRI進(jìn)一步確定責(zé)任椎間盤。
[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.
【作者單位】： 廣東省英德市人民醫(yī)院;
【分類號(hào)】：R681.53

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