MRI增强扫描指导腰椎间盘突出症诊断及退变程度评估的价值  

Value of MRI enhancement scan in the diagnosis of lumbar disc herniation and evaluation of degeneration degree

作　　者：朱伟滨 Zhu Wei-bin(Imaging Department,Shaxian District General Hospital,Sanming 365500,Fujian,China)

机构地区：[1]三明市沙县区总医院影像科,福建三明365500

出　　处：《四川生理科学杂志》2024年第11期2552-2554,共3页

摘　　要：目的:探究磁共振成像(Magnetic resonance imaging,MRI)增强扫描指导腰椎间盘突出症诊断及退变程度评估的价值。方法:选取2021年1月至2023年12月疑似腰椎间盘突出症患者300例为研究对象,均行腰椎MRI增强扫描,以临床最终诊断为金标准,评价MRI增强扫描指导腰椎间盘突出症诊断价值。确诊的腰椎间盘突出症患者根据退变程度分为轻度、中度和重度组,采用日本骨科学会评分(Japanese Orthopaedic Association,JOA)评估腰椎间盘突出症患者腰椎功能,采用Pearson相关系数评价MRI增强扫描血管渗透性参数与JOA评分的相关性。结果:经临床诊断300例疑似腰椎间盘突出症患者最终确诊264例(腰椎间盘突出症组),36例排除腰椎间盘突出症(非腰椎间盘突出症组)。MRI增强扫描诊断灵敏度为96.59%(255/264),特异度为97.22%(35/36),准确度为96.67%(290/300)。腰椎间盘突出症组容量转移常数(Volume transfer constant,K^(trans))高于非腰椎间盘突出症组(P<0.05)。不同退变程度患者K^(trans)的比较,差异有统计学意义(P<0.05);K^(trans)在轻度、中度和重度组患者中依次升高。Pearson相关分析结果显示,腰椎间盘突出症患者K^(trans)与JOA评分呈负相关(r=-0.726,P<0.05)。结论:MRI增强扫描指导腰椎间盘突出症诊断价值高,且K^(trans)可用于患者退变程度的评估。Objective:To explore the value of MRI enhancement scan in the diagnosis of lumbar disc herniation(LDH)and evaluation of degeneration degree.Methods:Atotal of 300 patients with suspected LDH were enrolled as the research objects between January 2021 and December 2023,all underwent lumbar MRI enhancement scan.Taking final clinical diagnosis as the golden standard,diagnostic value of MRI enhancement scan in LDH was evaluated.According to degeneration degree,patients with confirmed LDH were divided into mild group,moderate group and severe group.The lumbar function in patients with LDH was evaluated Japanese Orthopaedic Association(JOA).The correlation between vascular permeability parameters in MRI enhancement scan and JOA score was evaluated by Pearson correlation coefficient.Results:In the 300 patients with suspected LDH,clinical diagnosis showed that there were 264 cases with LDH(LDH group)and 36 cases without(non-LDH group).The diagnostic sensitivity,specificity and accuracy of MRI enhancement scan were 96.59%(255/264),97.22%(35/36)and 96.67%(290/300),respectively.Volume transfer constant(K^(trans))in LDH group was higher than that in non-LDH group(P<0.05).There were significant differences in K^(trans) among patients with different degeneration degree(P<0.05).K^(trans) was gradually increased in mild group,moderate group and severe group.The results of Pearson correlation analysis showed that K^(trans) was negatively correlated with JOA score(r=-0.726,P<0.05).Conclusion:The diagnostic value of MRI enhancement scan is high in lumbar disc herniation,and K^(trans) can be applied to evaluate degeneration degree.

关 键 词：腰椎间盘突出症 MRI增强扫描 诊断 退变程度 日本骨科学会评分 

分 类 号：R68[医药卫生—骨科学] R445[医药卫生—外科学]