Sequeiros R Blanco, Niinimäki J, Ojala R, Haapea M, Vaara T, Klemola R, Tervonen O
Department of Radiology, Musculoskeletal Division, Brigham and Women's Hospital, Boston, Mass 02115, USA.
Acta Radiol. 2006 Apr;47(3):272-80. doi: 10.1080/02841850500447229.
To describe the in vivo appearance of magnetic resonance imaging (MRI) diskograms of normal and degenerated lumbar intervertebral disks, and to evaluate the differences in imaging findings between sequential diagnostic MRI and MRI diskography.
Nine consecutive patients underwent MRI-guided diskography in order to determine possible pain provocation during puncture and contrast medium injection. All patients had preceding clinical suspicion of lumbar diskogenic pain and findings of lumbar disk degeneration in diagnostic (MRI, computed tomography (CT), plain radiography). A 0.23T open MRI scanner with interventional tools was used for imaging and instrument guidance. On all patients, a complementary diagnostic MRI study of the lumbar spine before and after the MRI-guided disk injection was performed, and subsequent axial MRI diskograms were obtained.
A total of 25 disk punctures were initialized, and 25 MRI diskograms were obtained and their expression described. There was a correlation between the degenerative disk findings visualized by diagnostic MRI and MRI diskograms.
The use of gadolinium contrast media in MRI-guided diskography enables the evaluation of MRI diskograms. Our results suggest that MRI-guided diskography can be used to substitute conventional diskography or CT-diskography and as an augmenting method to assess diagnostic information upon degenerative processes of the lumbar spine.
描述正常和退变腰椎间盘的磁共振成像(MRI)椎间盘造影的体内表现,并评估连续诊断性MRI与MRI椎间盘造影在影像学表现上的差异。
9例连续患者接受了MRI引导下的椎间盘造影,以确定穿刺和注射造影剂过程中是否可能引发疼痛。所有患者之前临床上均怀疑有腰椎间盘源性疼痛,且在诊断性(MRI、计算机断层扫描(CT)、X线平片)检查中发现有腰椎间盘退变。使用一台带有介入工具的0.23T开放式MRI扫描仪进行成像和器械引导。对所有患者在MRI引导下椎间盘注射前后进行了腰椎的补充诊断性MRI检查,并获得了后续的轴向MRI椎间盘造影图像。
共进行了25次椎间盘穿刺,获得了25张MRI椎间盘造影图像并对其表现进行了描述。诊断性MRI所见的退变椎间盘表现与MRI椎间盘造影之间存在相关性。
在MRI引导下的椎间盘造影中使用钆对比剂能够对MRI椎间盘造影进行评估。我们的结果表明,MRI引导下的椎间盘造影可用于替代传统的椎间盘造影或CT椎间盘造影,并作为一种辅助方法来评估腰椎退变过程中的诊断信息。