游离型腰椎间盘突出的MRI表现

MRI Manifestations of Free Lumbar Intervetebral Disk Herniation

目的 研究游离型腰椎间盘突出在MRI中的表现及诊断价值。资料与方法 回顾性分析 2 4例经手术病理证实的游离型腰椎间盘突出患者的MRI表现。结果 2 4例游离髓核中 ,2 3例位于椎管内硬膜外 ,其中 15例见于椎弓根内侧缘 ,5例位于椎间孔处 ,3例位于黄韧带区 ;仅 1例位于髓外硬膜下。 2 4例均为单发病灶 ,呈卵圆形、圆形或不规则形 ;游离髓核于T1WI上呈等或低信号 ,T2 WI上呈等或高信号 ,当有钙化时 ,呈低信号灶。其中 10例作了增强扫描 ,病灶中心部分均无强化表现 ,有 4例呈边缘强化。结论 MRI对游离髓核能作出正确的诊断 ,是首选的检查方法。

Objective To discuss MRI signs of free lumbar intervetebral disk herniation, and to evaluate MRI in its diagnosis.Materials and Methods MRI findings in 24 patients with pathologically proved free lumbar intervetebral disk herniation were retrospectively analyzed.Results Of 24 cases, the location of the free pulpiforn neucleus was extradural and intraspinal in 23, of which 15 were situated at vertebral arch, 5 at intervetebral foramen and 3 at ligamentum flavum area. In the remaining one case, the free pulpiforn neucleus was extramedullary and subdural. The lesion was single in all cases with oval, round or irregular shape, which displayed iso- or hypo-signal on T 1WI and iso- or hyper-signal on T 2WI. The calcification, if any, presented as low-signal area. Enhanced scanning was performed in 10 cases. Marginal enhancement was seen in 4 cases, and no enhancement was found in the central part of the lesion.Conclusion MRI can clearly demonstrate the free pulpiforn neucleus and make a correct diagnosis. Therefore, MRI is the exam of choice for the diagnosis of free lumbar intervetebral disk herniation.