磁共振成像与CT对腰椎间盘突出症的诊断价值探讨

Diagnostic value of magnetic resonance imaging and CT in lumbar disc herniation

目的 探究腰椎间盘突出症患者应用磁共振成像与CT的诊断价值。方法 60例腰椎间盘突出症患者作为研究对象,均接受CT和磁共振成像诊断。以手术结果作为金标准,比较两种诊断方法对不同病理分型及阳性征象的检出率。结果 手术诊断结果 :膨隆型16例,突出型25例,脱垂游离型5例, Schmorl结节14例。两种诊断方法对膨隆型、脱垂游离型、Schmorl结节的检出率比较差异无统计学意义(P>0.05);磁共振成像对突出型的检出率100.00%高于CT的76.00%,差异有统计学意义(P<0.05)。两种诊断方法对神经根受压的检出率比较差异无统计学意义(P>0.05);CT对钙化的检出率51.67%、椎间盘积气的检出率73.33%高于磁共振成像的3.33%、1.67%,差异有统计学意义(P<0.05);磁共振成像对硬膜囊受压的检出率78.33%、脊髓变性的检出率13.33%、椎间盘变性的检出率93.33%高于CT的45.00%、1.67%、0,差异有统计学意义(P<0.05)。结论 在腰椎间盘突出症脊髓变性、硬膜囊受压、椎间盘变性等方面磁共振成像更具优势,而在钙化、椎间盘积气方面CT更具优势,因此临床应根据患者的实际情况选择诊断方法。

Objective To investigate the diagnostic value of magnetic resonance imaging and CT in lumbar disc herniation.Methods 60 patients with lumbar disc herniation were studied,all of which received CT and magnetic resonance imaging diagnosis.Surgical results were used as the gold standard to compare the detection rates of the two diagnostic methods for different pathological types and positive signs.Results Surgical diagnosis:16 cases of bulging type,25 cases of protrusive type,5 cases of prolapsed free type,14 cases of Schmorl's nodules.There was no statistically significant difference in the detection rates of bulging type,prolapsed free type and Schmorl's nodules between the two diagnostic methods(P>0.05).The detection rate of magnetic resonance imaging for protrusive type was 100.00%,which was higher than 76.00%of CT,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the detection rate of nerve root compression between the two diagnostic methods(P>0.05).The detection rates of 51.67%for calcification and 73.33%for disc pneumatization by CT were higher than those of 3.33%and 1.67%by MRI,and the differences were statistically significant(P<0.05).The detection rates of 78.33%for dural sac compression,13.33%for spinal cord degeneration,and 93.33%for disc degeneration by magnetic resonance imaging were higher than those of 45.00%,1.67%,and 0 by CT,and the differences were statistically significant(P<0.05).Conclusion Magnetic resonance imaging has more advantages in lumbar disc herniation of spinal cord degeneration,dural sac compression and disc degeneration,while CT has more advantages in calcification and disc pneumatization.Therefore,clinical diagnosis should be selected according to the actual situation of patients.