腰椎管内椎间盘游离髓核的MRI诊断

MRI diagnosis of intervertebral disc free pulpiform nucleus in intraspinal lumbar

目的观察腰椎管内椎间盘游离髓核的MRI表现及诊断价值。方法回顾性分析28例经手术后病理证实的腰椎管内椎间盘游离髓核患者MRI征像。结果28例腰椎管内游离髓核均位于硬膜外间隙前部。游离髓核在椎管内向上游走5例,向下游走19例,向后水平游走4例;占据右隔区14例,左隔区10例,中线隔区4例。游离髓核与供体椎间盘髓核呈等或稍低信号,5例见班点状钙化呈更低信号。其形态呈圆形、卵圆形及片带状不规则形。其中5例行GD-DTPA对比剂增强扫描,病灶中心均无强化表现,边缘均有环形中、高度强化。结论正确的扫描方法能准确显示腰椎管内游离髓核,MRI是确诊的首选方法。

Objective To observe the MR/findings and diagnosticvalue of lumbar intraspinal intervertebral disc free pulpiform nucleus. Methods MRI findings of 28 cases with free pulpiform nucleus proved by surgery and pathology were retrospectively analyzed. Results Of the all cases, the free pulpiform nucleus located at extradural foreside. 5 cases dissociated upon in spinal, 19 cases moved down and 4 cases removed backwards. Of 28 patients, 14 cases inhabited right and 10 cases left and 4 cases midline. The free pulpiform nucleus had the same equal or low signal with provided intervertebral disc, 5 cases with flecky calcification showed lower signal. They had round shape, or oval or anormaly form. Among these 5 cases there were injected GD- DTPA with no enhancement in the center ,but mild and high enhancement at periphery. Conclusion Correct scan technique can exactly show lumbar intervertebral disc free pulpiform nucleus intraspinal.MRI should be the ftrst choice for diagnosis.