Böhm B, Meinig H, Eckardt A, Schadmand-Fischer S, Heine J
Orthopädische Klinik, Johannes-Gutenberg-Universität Mainz.
Orthopade. 2005 Nov;34(11):1144-9. doi: 10.1007/s00132-005-0858-x.
MRI can be too sensitive for detecting degenerative changes and commonly displays pathology that is not necessarily responsible for the patient's symptoms.
Retrospectively, we investigated MRI findings and results of discography in 23 patients with lower back pain. MRI investigations were performed with a 1.0 and 1.5 Tesla device using T1-weighted and T2-weighted sagittal plane imaging and T2-weighted transverse plane imaging.
Of the 35 degenerated discs, 16 were detected on MRI as having a high intensity zone (HIZ). Eleven of the 35 segments had previous lumbar disc surgery with a HIZ rate of 81.8%, whereas the HIZ rate for unoperated segments was only 29.2%.
HIZ is known to be a common lesion found using MRI in lower back pain patients. In operated segments, we found an incidence of 81.8% and in unoperated segments of 28.2%. Discography can discriminate between painful and non-painful discs. With the help of additional parameters such as contrast mean volume and pain characteristics during puncture, the number of false positive discograms can be reduced.
MRI对检测退变改变可能过于敏感，常显示出不一定导致患者症状的病变。
我们回顾性研究了23例下背痛患者的MRI表现和椎间盘造影结果。使用1.0和1.5特斯拉设备进行MRI检查，采用T1加权和T2加权矢状面成像以及T2加权横断面成像。
在35个退变椎间盘中，MRI检测到16个有高强度区（HIZ）。35个节段中有11个曾接受过腰椎间盘手术，HIZ发生率为81.8%，而未手术节段的HIZ发生率仅为29.2%。
已知HIZ是下背痛患者MRI检查中常见的病变。在手术节段，我们发现发生率为81.8%，在未手术节段为28.2%。椎间盘造影可以区分疼痛和无疼痛的椎间盘。借助诸如造影剂平均体积和穿刺时疼痛特征等附加参数，可以减少假阳性椎间盘造影的数量。
