腰腿痛的CT及MRI诊断分析

Analysis of CT and MRI in the Diagnosis of Lumbocrural Pain

目的分析CT与MRI诊断腰腿痛的影像学特点并比较两种检查方法在腰腿痛病因明确方面的临床价值。方法选择我院2013年10月-2015年10月期间收治66例因腰腿痛就诊的患者作为研究对象,所有患者均予以CT检查与MRI检查,分析影像学表现并明确病因。结果 CT与MRI检查发现患者腰腿痛主要原因包括椎间盘膨大与突出、腰椎退变(增生及疏松)、椎间盘变性、椎管狭窄、腰椎滑脱、终板炎(许莫结节)、腰椎(管)肿瘤、腰肌劳损等,其中MRI检查对椎间盘变性、腰肌劳损的确诊率高于CT,差异有统计学意义(P<0.05)。结论 CT与MRI在腰腿痛临床诊断中均有较大应用价值,其中CT由于扫描范围有限,检查层面不同,脊髓肿瘤漏诊误诊可能性较大,对终板炎、腰椎退变、椎体肿瘤所引起疼痛的显示不如MRI,因而可将MRI作为首选检查方法,若医院无MRI设备,也可将CT作为替代方法。

Objective To analyze the imaging characteristics of CT and MRI in the diagnosis of lumbocrural pain and to compare the clinical value of the two kinds of examination methods in determination of the causes of lumbocrural pain. Methods 66 patients with lumbocrural pain treated in our hospital from October 2013 to October 2015 were treated as the research objects. All patients were examined with CT and MRI. The imaging findings were analyzed and the causes were determined. Results CT and MRI examination found that the main causes of lumbocrural pain in patients included intervertebral disc intamescentia and extrusion, degeneration of the lumbar spine column（hyperplasia and osteoporosis）, intervertebral disc degeneration, spinal stenosis, spondylolisthesis, endplate inflammation（Schmorl nodes）, lumbar（tube） tumor and lumbar muscle strain, etc.. The confirmed diagnosis rates of MRI examination of intervertebral disc degeneration and lumbar muscle strain were higher than those of CT（P〈0.05）. Conclusion CT and MRI in the clinical diagnosis of lumbocrural pain has great application value, of which due to the limited scope of scanning and different examination levels, the possibility of CT in missed diagnosis and misdiagnosis of spinal cord tumor is larger. The display of pain induced by endplate inflammation, degeneration of the lumbar spine column and vertebral tumors is not as good as MRI, thus MRI is the preferred method of inspection. If there is no MRI equipment in the hospital, CT can be taken as an alternative method.