MRI 在腰椎间盘突出患者诊断及术后评估中的应用价值

Clinical value of MRI in diagnosis and postoperative evaluation of patients with lumbar disc herniation

目的探讨核磁共振成像(MRI)检查用于老年腰椎间盘突出(LDH)患者诊断及术后效果评估的临床价值。方法选择于2020年4月~2022年3月本院收治的腰椎间盘突出患者103例,所有患者均进行电子计算机断层扫描(CT)及MRI检查,且均行经皮椎间孔镜下髓核摘除手术(PELD)。分别对比CT和MRI对于硬膜囊受压、椎间盘变形、椎间盘钙化、椎间盘积气、神经根受压的检出率,分析手术疗效与术前MRI特征的相关性。结果MRI对于硬膜囊受压、椎间盘变形、椎间盘钙化、椎间盘积气、神经根受压的检出率明显高于CT检查(P<0.05);PELD术后患者视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分明显低于术前(P<0.05),且术前MRI特征侧隐窝大小、椎间孔上下径、椎间孔前后径、椎间隙高度均与术后VAS评分、ODI指数评分呈负相关(P<0.05)。结论MRI可用于LDH的术前诊断,并对手术疗效进行预测和评估。

Objective To investigate the clinical value of magnetic resonance imaging(MRI)in the diagnosis and postoperative evaluation of elderly patients with lumbar disc herniation(LDH).Methods:103 patients with LDH admitted to our hospital from April 2020 to March 2022 were selected as the research subjects.All patients received computerized tomography(CT)and MRI,and underwent percutaneous endoscopic lumbar discectomy(PELD).The detection rates of dural sac compression,intervertebral disc deformation,intervertebral disc calcification,intervertebral disc gas accumulation,and nerve root compression were compared between CT and MRI.The correlation between surgical effect and preoperative MRI features was analyzed.Results:The detection rates of dural sac compression,intervertebral disc deformation,intervertebral disc calcification,intervertebral disc gas accumulation,and nerve root compression by MRI were significantly higher than CT(P<0.05).The Visual Analogue Scale(VAS)scores and Oswestry disability index(ODI)scores after PELD were significantly lower than those before surgery(P<0.05).The preoperative MRI features,including lateral recess size,vertical diameter of intervertebral foramen,anteroposterior diameter of intervertebral foramen and intervertebral space height,were negatively correlated with postoperative VAS score and ODI score(P<0.05).Conclusion:MRI can be used for preoperative diagnosis of LDH,and to predict and evaluate the surgical effect.