负重位MRI对腰椎隐匿性椎管狭窄的诊断价值

Diagnostic value of weight bearing MRI in patients with occult spinal stenosis

目的：探讨负重位MRI检查对腰椎隐匿性椎管狭窄的诊断意义。方法：收集临床有神经功能障碍而常规MRI或CT检查无明显异常或影像征象与临床体征不一致的76例患者,患者行负重位MRI检查,观察分析下腰椎（L3~4、L4~5、L5~S1）椎管变化情况。结果：76例患者228个椎间盘水平负重位MRI检查发现28例（36.84%）32个（14.04%）硬膜囊面积〈75 mm2。其中11个由椎间盘膨出或突出造成,10个由椎间盘病变与黄韧带共同作用造成,7个由椎体失稳或滑脱造成,4个由小关节半脱位造成。此外,负重位MRI还发现5例（6.58%）椎间盘极外侧型突出,14例（18.42%）23个椎间孔狭窄。结论：负重位MRI可弥补常规MRI或CT检查的不足,为腰椎隐匿性椎管狭窄的诊断提供可靠依据。

Objective：To evaluate the lumbar occult spinal stenosis with weight bearing MRI. Methods：Weight beating MRI was performed in 76 cases with neurogenie deficiency symptoms without distinct compression in conventional MRI or CT examination or imaging results inconsistent with the clinical signs. The disc levels from L3 to S1 were examined. Results：28 cases （36.84%） 32 （14.04%） with dural sac cross-sectional area 〈75 mm2 were newly discovered in 76 cases with 228 intervertebral disc. 32 occult spinal stenosis,in which ll caused by bulging or protruding intervertebral discs,10 caused by the interaction with the disc disease and yellow ligament,7 caused by spondylolisthesis,4 caused by facet joint subluxation. In addition,weight beating MRI also found 5 cases （6.58%） with extreme lateral disc herniation and 14 （18.42%） cases with 23 foramen stenosis. Conclusions：Weight beating MRI can demonstrate occult spinal stenosis which cannot be detected in conventional MRI or CT, and provide a reliable evidence for the diagnosis of occult spinal stenosis.