MRI对腰椎纤维环后部破裂的诊断价值

The value of MRI in the diagnosis of lumbar annulus fibrosus tears

目的明确腰椎MRI对诊断疼痛性纤维环破裂的敏感性。方法收集近 2年因腰椎间盘退变伴下肢放射痛而手术的患者47例，所有患者腰椎 MRI均有高信号区 (high-intensity zone， HIZ)表现。通过比较手术结果与 MRI影像学资料，对 MRI诊断纤维环后部破裂的敏感性作出评价。结果共研究 47例，手术探查 105个椎间盘。其中 HIZ椎间盘 56个，手术证实阳性率 85.7％，假阳性率 14.3％；无 HIZ椎间盘 49个，手术证实阴性率 87.8％，假阴性率 12.2％。结果表明 MRI诊断纤维环后部破裂的敏感性为 88.9％，特异性为 84.3％。结论 HIZ是诊断疼痛性腰椎纤维环后部破裂的特异性和敏感性较高的影像学标准。

Objective To determine the accuracy of MRI in detection of painful tears of the lumbar annulus fibrosus by high intensity zone (HIZ). Methods Annulus fibrosus tears were identified in MRI by the presence of a HIZ in the posterior annulus. The accuracy and specificity of MRI were compared with the surgical findings. Results One hundred and five discs in 47 patients with radicular pain were examined on operation. Fifty-six discs with HIZ were identified in MRI, of which 48 had annular fibrosus tears during the operation. Forty-nine discs without HIZ were identified in MRI, of which 43 had no annular tears found during operation. The accuracy and specificity of MRI in the diagnosis of painful posterior annular tears were 88.9％ and 84.3％ respectively. Conclusion The results confirm that the high-intensity zone is a marker of a painful posterior annular tear, with high accuracy and specificity.