磁共振SPACE序列在诊断极外侧椎间盘突出中的临床应用  

The Clinical Usage of MR-SPACE Sequence in Diagnosis of Far Lateral Lumbar Disc Herniation

作　　者：许道洲[1] 夏好成[1] 罗树彬[1] 吕海莲[1] 冯国平[2] 许蕾[1] 肖文丰[1] 王忠[3] 

机构地区：[1]山东省东营市胜利油田中心医院磁共振科 [2]山东省东营市胜利油田中心医院急诊科 [3]西门子(中国)有限公司培训部

出　　处：《中国医学计算机成像杂志》2011年第4期356-360,共5页Chinese Computed Medical Imaging

摘　　要：目的：探讨磁共振不同序列在极外侧椎间盘突出上的表现及诊断价值。方法：对经手术证实的5例极外侧椎间盘突出患者的磁共振常规扫描图像、SPACE序列图像及临床资料进行回顾性分析。结果：本组5例均为男性，年龄32～53岁，平均34岁。椎间孔内侧型2例，椎间孔外侧型2例，混合型1例。极外侧椎间盘突出在平扫矢状位椎间孔层面上表现为椎间孔内和（或）外软组织肿块信号，形态多呈圆形、卵圆形或不规则形，T2WI轴位呈等或混杂信号，边缘不清，T2WI冠状位呈位于孔内和（或）外软组织肿块信号，硬膜囊受压，强化扫描呈中央不强化，周边环状强化信号；SPACE序列冠状位椎间孔周围出现异常低信号，呈圆形、卵圆形或不规则形并与线状马尾神经根相交；SPACE—STIR序列显示受压移位的神经根与突出的椎间盘呈“腋下网球”样征象。结论：在磁共振SPACE序列上能直观地显示神经根与椎间盘之间空间关系，具有一定的特征性，对临床的定性及定位诊断有重要参考价值。Purpose： To investigate the MRI manifestations and value of different sequences in diagnosis of far lateral lumbar disc herniation.Methods： The clinical data, MRI images with routine scan and SPACE sequence of 5 patients with far lateral lumbar disc herniation proved by operations were analyzed retrospectively. Results： There were 5 cases （all male, average age 34 years, range 32- 53 years） in this group. Two patients were medial intervertebral foramina type, 2 were lateral and 1 were mixed type. MR features of far lateral lumbar disc herniation in sagittal view at intervertebral foramen plane were soft - tissue masses inside and/or outside intervertebral foramen. The shape was round, orbicular - ovate and irregular. Axial T2WI showed isointensity or mixed signal with unclear boundary. Coronal T2WI showed soft - tissue masses inside and/or outside intervertebral foramen with compression of dural sac. Enhanced scan showed annular enhancement with an enhanced center. Abnormal low signal was found beside intervertebral foramen at coronal view in SPACE sequence. It appeared rounding, orbicular - ovate and irregular, and was intersecting with linear cauda equina. SPACE- STIR sequence could display sign of oxter tennis which composed by herniated lumbar disc and compressed, displaced nerve root. Conclusion： The MR SPACE sequence findings for far lateral lumbar disc herniation are typical. This sequence has great significance in clinical localization and qualitative diagnosis.

关 键 词：极外侧椎间盘 椎间盘 突出 神经根 磁共振成像 SPACE—STIR序列 SPACE序列 

分 类 号：R445.2[医药卫生—影像医学与核医学]