218例腰椎间盘突出症的CT表现与手术对照

CT findings and surgical comparison in patients with lumbar disc herniation: analysis of 218 cases

目的 :提高CT对腰椎间盘突出症 (LDH)的诊断水平 ,为临床合理选择治疗方法提供依据。方法 :对CT诊断为LDH并经手术探查的 2 18例资料进行回顾性对照分析 ;依据其椎间盘突出部位及主要病理改变对LDH进行分型。结果 :CT诊断符合率为 95 4% (2 0 8/ 2 18) ,其中LDH分为中央型 (n =5 1)、偏侧型 (n =183)、椎间孔型 (n =18)、极外侧型 (n =4)及脱出型(n =6 )。结论 :CT对LDH的诊断和对临床合理选择治疗方案有重要价值。重视区分髓核脱出及纤维组织增生对提高LDH的CT诊断率和疗效有重要意义。

Objective:To improve the diagnostic accuracy in lumbar disc herniation (LDH) by CT and to provide the basis of rational clinical therapies. Methods:Two hundred and eighteen patients with LDH were examined by CT and operative exploration. LDH was divided into several types according to the location of herniated discs and the principal pathologic findings. Results:Compared with surgical findings the CT diagnostic corresponding rate of LDH was 95 4%(208/218). Herniated lumbar discs were divided into five types: central ( n =51), postero lateral ( n =183), foraminal ( n =18), extreme lateral ( n =4) and herniated nucleus pulposus ( n =6). Conclusion:CT has played an important part in diagnosis and adopting appropriately clinical treatment of LDH. It is of great significance to improve the diagnostic rate of CT and the treatment effectiveness by distinguishing herniated nucleus pulposus and proliferation fibrous tissue. [