基于德尔菲法探究腰椎间盘突出MRI影像诊断路径

Exploring the diagnostic pathway of MRI imaging of lumbardisc herniation based on the Delphi method

目的:对诊断腰椎间盘突出MRI影像条目权重开展研究,以形成优化统一的影像诊断路径。方法:提取文献中关于腰椎间盘突出MRI影像诊断的语句、关键词和相关词汇建立条目池,采用头脑风暴法对条目进行讨论,将讨论后的条目结合Likert 5级重要性分级构建问卷,使用德尔菲法开展专家咨询,并依据咨询结果计算诊断腰椎间盘突出MRI影像条目的权重系数,通过对权重系数排序以形成影像诊断路径。结果:本研究形成的影像诊断路径如下:神经根受压(LNRC)、髓核水分(LNPM)、椎间盘形态与高度(LDMAH)、脑脊液通畅情况(CFP)、马尾神经走行(CEL)、纤维环完整性(LDFRI)、后纵韧带完整性(PLLI)、髓核与纤维环分界(NPAFRD)、椎体稳定性(LVBS)、终板形态(LEM)、骨质增生(LVO)、Modic改变(MC)及Schmorl结节(SN)。结论:本研究的腰椎间盘突出MRI影像诊断路径能为影像智能诊断提供基础条件,并为相关影像研究提供参考。

Objective:To study the weighting of MRI images of lumbar disc herniation in order to develop an optimal and uniform diagnostic imaging pathway.Methods:After reading the literature,we extracted statements,keywords and related words about the diagnosis of MRI images of lumbar disc herniation to establish a pool of entries,discussed the entries by brainstorming method,constructed a questionnaire by combining the discussed entries with Likert s five levels of importance,conducted expert consultation using the Delphi method,and calculated the weight coefficients of MRI images of lumbar disc herniation based on the consultation results and the diagnostic imaging pathway is formed by ordering the weight coefficients.Results:The following diagnostic imaging pathways were developed:nerve root compression(LNRC),nucleus pulposus moisture(LNPM),disc morphology and height(LDMAH),cerebrospinal fluid patency(CFP),cauda equina travel(CEL),fibrous ring integrity(LDFRI),posterior longitudinal ligament integrity(PLLI),nucleus pulposus-fibrous ring demarcation(NPAFRD),vertebral body stability(LVBS),endplate morphology(LEM),osteophytes(LVO),Modic changes(MC),and Schmorl s nodes(SN).Conclusion:The MRI imaging diagnostic pathway of lumbar disc herniation explored in this study can provide the basic conditions for later imaging intelligent diagnosis and reference for related imaging studies.