MR增强扫描对腰椎间盘脱出髓核游离的手术方式选择的影响  

Effect of enhanced MR scanning on the choice of operative methods for prolapse of lumbar disc protrusion and nucleus pulposus dissociation

作　　者：周欣 张勇鹏 ZHOU Xin;ZHANG Yong-peng(No.215 Hospital of Shaanxi Nuclear Industry, Xianyang 712000, China)

机构地区：[1]陕西省核工业二一五医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2019年第6期133-135,共3页Clinical Research and Practice

摘　　要：目的分析磁共振(MR)增强扫描判断腰椎间盘脱出髓核与周围组织的粘连程度及指导手术方式的效果。方法 44例腰椎间盘脱出髓核游离患者术前均行MR平扫及增强扫描,增强扫描评估髓核强化程度,术中评估髓核周围炎性粘连程度及手术难度,术后将髓核强化程度与髓核周围粘连程度做相关性分析。按照髓核游离的强化程度分为不强化组(28例)、轻度强化组(10例)及中度强化组(6例)。结果 28例患者磁共振增强后髓核游离不强化,术中髓核周围无粘连,手术易剥离;10例髓核呈轻度强化,其中8例周围有粘连,手术不易剥离,2例周围无粘连,手术易剥离;6例髓核呈中度强化,手术剥离困难。髓核的强化程度与周围粘连有相关性(r=0.745,P<0.05)。结论 MR增强扫描可在术前判断髓核游离的位置及周围炎性粘连情况,间接判断手术难易程度,从而为手术方案的选择提供帮助。Objective To analyze the effect of enhanced magnetic resonance(MR) scanning judging the degree of adhesion between nucleus pulposus and surrounding tissues of lumbar intervertebral nucleus pulposus dissociation and guiding the operation methods. Methods All 44 patients with lumbar disc protrusion and nucleus pulposus dissociation underwent MR plain scanning and enhanced scanning before operation. The degree of nucleus pulposus enhancement was evaluated by enhanced scan. The degree of inflammatory adhesion around nucleus pulposus and the difficulty of operation were evaluated during operation. The correlation between the degree of nucleus pulposus enhancement and the degree of adhesion around nucleus pulposus was analyzed after operation. According to the degree of enhancement of nucleus pulposus dissociation, the patients were divided into non-enhancement group(28 cases), mild enhancement group(10 cases) and moderate enhancement group(6 cases). Results The nucleus pulposus dissociation of 28 patients did not strengthen after enhanced magnetic resonance, and there was no adhesion around the nucleus pulposus during the operation, so the operation was easy to peel off;10 cases showed slight enhancement, including 8 cases with adhesion around the nucleus pulposus, which was not easy to peel off, 2 cases without adhesion around the nucleus pulposus, which was easy to peel off;6 cases showed moderate enhancement, which was difficult to peel off. The degree of nucleus pulposus enhancement was correlated with peripheral adhesion(r=0.745, P<0.05). Conclusion Enhanced MR scanning can be used to determine the free position of nucleus pulposus and the inflammatory adhesion around the nucleus pulposus before operation, and indirectly to judge the degree of difficulty in operation, it is helpful for the choice of operative methods.

关 键 词：腰椎间盘脱出 髓核游离 磁共振 

分 类 号：R681.53[医药卫生—骨科学]