高磁场磁共振成像对髓核突出的诊断

MR assessment on the nucleus pulposus herniation

高磁场磁共振(MR)可行薄切层、任意角度检查,其所提供的高质量图像,具有无损伤、安全特点,可直接分析各种骨质及软组织结构的病变,并能推测组织化学成份改变。作者对34例患者44个部位髓核突出术前行磁共振检查,诊断结果与手术及病理所见相比较,发现磁共振确诊率为93.2％,敏感性为100％。作者对此做回顾性分析,有如下特点:①MR多角度成像避免了CT受扫描节段性限制的缺点,本组多发性髓核突出8例,占23.5％.②MR对鉴别是否为穿韧带型突出确诊率高达83.3％,为采用手术切除或经皮髓核切除的选择提供关键性依据。③依手术及病理发现探讨髓核突出增强原理及纤维环破裂的依据。

Thin resolution MR imaging has the advantages of safety and without the need for intervention. The high quality picture allows not only to visulize the various bony and soft-tissue structures but also to analyse the chemical changes. A prospective study was undertaken to 34 patients with 44 nucleus polposus herniations who had MR examinations before operation. The results revealed that the accuracy of MR was 93. 2% and the sensitivity was 100% after compared with the operative and pathologic findings. We found its characteristics are: (1) The multiple herniations were to the high of 23. 5% because MR is possible to acquire images in multiple planes, relatively large areas of the spine can be screened initially in the sagittal plane and additional imaging can be performed axially at the levels of interest that superior to CT. (2) The differential diagnosis accuracy for extraligament herniation was 83. 3% and it provides a key basis for the choice of operation or nucleotome. (3) Judging by operative and pathological findings to discuss the Gd-DTPA enhancement of the fragment herniation and the signs of disrupted anulus fibrosis.