腰椎间盘突出症MRI部位和形态分型同病理类型的相关性研究

The Correlation Study of MRI Diagnosis Type with Pathomorphological Type in the Lumbar Disc Herniation

目的:明确腰椎MRI部位和形态分型同病理类型的相关性。方法:收集经手术病理证实并有完整MRI影像资料的90例,通过手术结果与影像特征对比观察,对部位和形态分型同病理分类的相关性做出客观评价。结果:椎间型75例。(1)惊叹号形26例,均为脱出型;(2)铆钉形24例,脱出型6例,突出型18例;(3)杵状11例,膨出型8例,突出型3例;(4)楔形14例,均为膨出型。椎体后型15例。(1)水滴形3例;(2)不规则团块形12例,病理类型均为破碎脱出游离型。结论:突出物的形态、部位分型,突出物与椎间隙内间盘母体、硬膜等周围组织的邻界征象是病理分类的重要依据。深层次认识不同征象的解剖和病理基础,能真正实现三维立体定位、定性、定量诊断,对治疗方法、手术方法选择和微创术式定位具有重要指导意义。

Objective： To determine the position of lumbar vertebrae MRI and the connective property with the same pathomorphological classification. Method： Ninty cases with the entire MRI and operative pathology verified were collected in this study. Compare with the result of the operation and MRI and evaluate the related property of the position and the same pathomorphological classification. Resuits： Intervertebral type 75 cases. （1） Exclamation Mark Form 26 cases, all are extrusion type. （2） Rivet Form 24 cases, 6 cases are extrusion, 18 cases are protrusion. （3） Pestle Form 11 cases, 8 cases are buling and 3 cases are protrusion. （4） Wedge Form 14 cases, all are buling. Post-vertebral type 15 cases： 3 cases are water drop form, and 12 are not putting in order. Pathomorphological type is sequestration. Conclusions：The protuberance whose shape, position and the near sign of round tissue with lumbar annulus fibrosus, dura mater of spinal are important foundation. To deeply understand the pathomorphological and anatomic foundation of differential MRI sign is very helpful to three-dimensional location diagnosis, therapeutic methods and location of micro-traumatic operation.