腰椎磁共振成像诊断椎间盘源性腰痛的临床价值  

CLINICAL VALUE OF MRI IN DIAGNOSING DISCOGENIC LOW BACK PAIN

作　　者：柳围堤[1] 杨斌辉[1] 张芳[1] 陈利军[1] 赵志友[1] 

机构地区：[1]西安交通大学医学院附属3201医院疼痛科,汉中723000

出　　处：《中国疼痛医学杂志》2013年第2期91-94,共4页Chinese Journal of Pain Medicine

摘　　要：目的：探讨椎间盘源性腰痛的磁共振成像（magnetic resonance imaging，MRI）诊断意义，为临床诊断提供参考。方法：分析本院疼痛门诊2007年9月～2011年6月期间诊疗的椎间盘源性腰痛患者的MRI数据，并进行统计学的对比分析。结果：67％椎间盘源性腰痛患者均有外伤史；间盘病变节段以L4/5和L5／S1为最常见；椎间盘源性腰痛患者在MR／上一般都有椎间盘低信号改变，常伴有高信号区（high intensity zone，HIZ）、软骨终板变性（Modic征）和Schmorl结节等。结论：MRI单节段间盘信号改变伴后外侧出现HIZ可以较可靠地说明该间盘为责任间盘；HIZ是较可靠的诊断椎间盘源性腰痛的标志性影像；Modic征和Schmorl结节在诊断中起重要参考作用。Objective： To explore the imaging diagnosis of the discogenic low back pain and offer a reference to the clinical diagnosis. Methods： The MRI data from September 2007 to June 2011 in patients with discogenic low back pain diagnosed and treated in our department were analyzed, and the statistical comparative analysis was conducted. Results： Most of the patients with discogenic low back pain had history of trauma; the most common ranges of the disc lesions were L4/5 and LJS1; the MRI of the patients who had discogenic low back pain presented low signal changes in the disc field which was always accompanied by high intensity zone （HIZ）, Modic changes and Schmorl nodes. Conclusions： With the signal changes of the certain intercalated disc on MRI and the presence of HIZ in the posterolateral field, the responsible disc can be reliably detected; HIZ is the reliable and symbolic image in the diagnosis of discogenic low back pain; Both the Modic changes and Schmorl nodes act as important references for the diagnosis of the discogenic low back pain.

关 键 词：椎间盘源性腰痛 磁共振成像 临床价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.53[医药卫生—诊断学]