红外热成像技术在LDH诊断及其射频消融术疗效评价中的应用

Application of infrared thermography in making LDH diagnosis and evaluating efficacy of radiofrequency ablation

目的探讨红外热成像技术在腰椎间盘突出症(LDH)诊断及其射频消融术疗效评价中的应用。方法LDH患者120例在DSA引导下采用腰椎间盘射频消融术治疗。治疗前后行Oswestry功能障碍指数(ODI)评分、日本矫形外科学会(JOA)评分、VAS疼痛评分及红外热成像技术检测,并行Macnab标准评定疗效。结果LDH患者红外热成像技术检测阳性率为90.83%。红外热成像技术、CT/MRI及患者自诉疼痛的神经支配部位阳性例数比较均无统计学差异(P>0.05)。120例患者均顺利完成射频消融术,优良率达89.17%。与治疗前比较,治疗后ODI评分和VAS疼痛评分下降,而JOA评分升高(P<0.05)。按照CT/MRI判定阳性部位为标准,治疗后膝部前侧、小腿内侧、小腿前外侧、小腿后侧、足底温差治疗前后比较差异有统计学意义(P<0.05),且疗效为优和良的阳性部位温差更大(P<0.05)。结论红外热成像技术可以作为LDH诊断的补充技术,能对疗效提供客观评价。

Objective To explore the application of infrared thermography in making the diagnosis of lumbar disc herniation(LDH)and evaluating the efficacy of radiofrequency ablation.Methods The DSA-guided radiofrequency ablation of lumbar intervertebral disc was performed in 120 patients with LDH.The changes of Oswestry Disability Index(ODI)score,Japanese Orthopaedic Association(JOA)score,VAS pain score and infrared thermography examination were detected before and after treatment.Macnab standard was used to evaluate the efficacy.Results The positive rate of infrared thermography was 90.83%.There were no statistical differences in the positive cases of innervation sites reported by infrared thermography,CT/MRI and patients’self-complained pain(P>0.05).Radiofrequency ablation was successfully performed in 120 patients with an excellent and good rate of 89.17%.Compared with before,ODI score and VAS pain score were decreased while JOA score was increased after treatment(P<0.05).According to CT/MRI to determine the positive site as the standard,there were significant differences in the temperature difference of the anterior knee,medial leg,anterolateral leg,posterior leg and planta pedis before and after treatment(P<0.05).The temperature difference on the positive site with excellent and good efficacy was greater(P<0.05).Conclusion Infrared thermography can be taken as a supplemental technique for the diagnosis of LDH,which may provide an objective efficacy evaluation.