Modic M T
Department of Radiology, Ohio State University College of Medicine, Columbus, USA.
Magn Reson Imaging Clin N Am. 1999 Aug;7(3):481-91, viii.
Although MR imaging has become the most accurate test for depicting abnormal morphology, there is no agreement on the diagnostic value of morphology alone. If the natural history of a disease is not clearly understood, and if there is little consensus, within or between specialties, regarding the use of diagnostic tests, the risk of misdiagnosis is high. Degenerative disc disease is costly, debilitating, and one of the most complex conditions to manage. This article discusses symptomatology, including instability and malalignment abnormalities, intervertebral disc degeneration or herniation, spinal stenosis, and facet disease, as treated in a variety of current studies; emphasis is placed on bridging the gaps between technology, areas that deserve further research, and sound clinical judgement.
尽管磁共振成像(MR)已成为描绘异常形态最准确的检查方法,但对于仅依据形态学进行诊断的价值尚无定论。如果对疾病的自然史了解不清,并且在各专业内部或之间对于诊断检查的应用几乎没有共识,那么误诊风险就会很高。椎间盘退变疾病代价高昂、使人虚弱,且是最难处理的复杂病症之一。本文讨论了当前各种研究中所涉及的症状学,包括不稳定和排列不齐异常、椎间盘退变或突出、椎管狭窄以及小关节疾病;重点在于弥合技术、值得进一步研究的领域与合理临床判断之间的差距。