Wang Hua-Dong, Hou Shu-Xun, Wang Xiao-Ning, Li Zhen-Zhou, Wu Wen-Wen
Department of Orthopaedics, the First Affiliated Hospital of General Hospital of People's Liberation Army, Beijing 100037, China.
Zhonghua Wai Ke Za Zhi. 2008 Jul 1;46(13):973-6.
To study correlation between high intensity zone (HIZ) of lumbar disc and positive pain response on lumbar discography for the diagnosis and treatment of discogenic low back pain.
Thirty-seven cases with chronic low back pain without neurologic symptoms and lumbar disc herniation on CT scan underwent lumbar discography and MRI examination. X-ray and CT after discography with positive pain response were analyzed to correlate with HIZ on MRI.
Ninety-eight discs underwent discography in 37 patients. Twenty-one discs presented positive pain response; including 10 have HIZ (47.6%). Seventy-seven discs presented negative pain response; including 29 had HIZ (37.6%). The higher grade of annular disruption group had the higher proportion of HIZ on lumbar MRI. There was a positive correlation between HIZ and degree of annular disruption. However, there was no correlation between HIZ and positive pain response on lumbar discography.
HIZ on lumbar MRI only can be a filtrated and suggestive image sign and can not replace discography in the diagnosis and treatment of discogenic low back pain.
研究腰椎间盘高强度区（HIZ）与椎间盘造影术阳性疼痛反应之间的相关性，以用于椎间盘源性下腰痛的诊断和治疗。
对37例慢性下腰痛且无神经症状、CT扫描无腰椎间盘突出症的患者进行椎间盘造影术和MRI检查。分析椎间盘造影术后疼痛反应阳性的X线和CT表现，并与MRI上的HIZ进行相关性分析。
37例患者共98个椎间盘接受了椎间盘造影术。21个椎间盘呈现阳性疼痛反应；其中10个有HIZ（47.6%）。77个椎间盘呈现阴性疼痛反应；其中29个有HIZ（37.6%）。腰椎MRI上，环形撕裂程度越高的组HIZ比例越高。HIZ与环形撕裂程度呈正相关。然而，HIZ与椎间盘造影术阳性疼痛反应之间无相关性。
腰椎MRI上的HIZ仅可作为一种筛选性和提示性的影像征象，在椎间盘源性下腰痛的诊断和治疗中不能替代椎间盘造影术。
