盘源性下腰痛患者CT腰椎间盘造影与MRI相关性研究

Correlation between MR imaging and CT discography with provocative concordant pain in patients with discogenic low back pain

目的 基于CT腰椎间盘造影术（CTD）诱发的一致性疼痛,研究盘源性下腰痛与MRI改变的相关性.方法 对盘源性下腰痛76例行MRI检查后实施CT腰椎间盘造影术,共计造影209个腰椎间盘,分析CTD分型、对比剂注射剂量、诱发的一致性疼痛与MRI改变的相关性.结果 在完成CTD检查的209个椎间盘中,83个诱发一致性疼痛；其CTD分型、对比剂注射剂量与诱发一致性疼痛具有相关性,腰椎间盘的MRI改变与造影诱发的一致性疼痛有明显的相关性.结论CT腰椎间盘造影术能定性诊断腰椎间盘内破裂,进一步确定责任椎间盘.盘源性下腰痛的病因可能与腰椎间盘MRI改变：Ⅳ～Ⅴ级退变、局限性高信号（HIZ）的出现、软骨终板及终板下骨髓信号异常（modic变性）相关.

Objective This study aimed to correlate magnetic resonance （MR） findings and CT discography （CTD） with provocative concordant pain in patients with discogenic low back pain （DLBP）. Methods Based on MR findings, CT discography was successfully carried out on 209 discs in 76 patients with DLBP. We evaluated correlation among the CTD group, dose of contrast medi- um, concordant pain by discography and MR findings. Results Discography was conducted on 209 discs successfully, 83 discs of which presented with concordant pain. The CTD groups, the numbers of contrast medium from positive and negative discs have significant difference. MR findings of discs and provocative concordant pain by CTD have significant difference. Conclusion CTD can show the sign of internal disc disruption directly,identified the symptomatic disc. Grade IV- V disc on MR images, the presence of HIZ, and end- plate abnormalities might indicate discogenic pain in patients with DLBP.