腰椎间盘脱出髓核游离的MRI表现与手术病理对照研究  

MRI Finding and Surgical Pathology of Lumbar Disc Extrution with Sequestered Fragment

作　　者：陈友三[1] 邓先波[1] 刘定西[1] 周敏[1] 王冰[1] 吴文骏[1] 孔祥泉[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2015年第7期1114-1118,共5页Journal of Clinical Radiology

摘　　要：目的探讨腰椎间盘脱出髓核游离的MRI表现与手术病理特征,提高对该病的诊断水平。方法回顾性分析经手术病理证实的38例腰椎间盘脱出髓核游离患者的临床表现、MRI特征、手术病理资料。结果 38例椎间盘脱出髓核游离发生在L3~4椎间盘2例,L4~5椎间盘17例,L5~S1椎间盘19例。38例中髓核上行游离11例,下行游离17例,平行游离10例。游离髓核呈圆形或椭圆形,在T1WI游离髓核以等信号为主（38例）,T2WI为等信号（22例）或稍高信号（16例）。19例行增强扫描显示环状强化（17例）或混杂不均等强化（2例）。结论 MRI检查对腰椎间盘脱出髓核游离诊断准确率高;髓核周围强化越明显,提示炎性反应及黏连越严重,手术分离难度越大。Objective To investigate magnetic resonance imaging findings and surgical pathology of lumbar disc extrution with sequestered fragment,in order to improve the diagnosis of this disease.Methods Clinical manifestations,surgical pathology results and characteristics of magnetic resonance imaging finding in 38 patients with pathologically proved lumbar disc extrution with sequestered fragment were retrospectively analyzed.Results 38 cases with lumbar disc extrution were located at lumbar spinal epidural space in front of L3 /4（2 cases）,L4 /5（17 cases）,or L5 / Sl（19 cases）; lower and level of migration were respectively 11,17 and 10.The form of the free pulpiform nucleus was round or oval.Free nucleus pulposus showed isointensity signal intensity（38 cases） on T1 weighted images,isointensity signal（22 cases） or slightly high signal intensity（16 cases） on T2 weighted images.Free nucleus pulposus were enhanced in 19 patients.17 cases showed ring-like enhancement and 2 cases showed mixed uneven enhancement.Conclusion Magnetic resonance imaging is a feasible and accurate approach to diagnose lumbar disc extrution with sequestered fragment.Enhancement around the nucleus pulposus is closely related to the inflammatory reaction and the degree of adhesion in surgery.

关 键 词：磁共振成像 腰椎 椎间盘疝 游离髓核 

分 类 号：R687.3[医药卫生—骨科学] R445.2[医药卫生—外科学]