在患有背痛的青少年中，椎弓根峡部裂经常被MRI漏诊。
Spondylolysis is frequently missed by MRI in adolescents with back pain.
作者信息
Yamaguchi Kent T, Skaggs David L, Acevedo Daniel C, Myung Karen S, Choi Paul, Andras Lindsay
机构信息
Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 W. Sunset Blvd., Mailstop #69, Los Angeles, CA 90027 USA.
出版信息
J Child Orthop. 2012 Jul;6(3):237-40. doi: 10.1007/s11832-012-0409-z. Epub 2012 Jun 3.
PURPOSE
Magnetic resonance imaging (MRI) is often used in the evaluation of lower back pain in adolescents. The purpose of our study is to report on the frequency of MRI missing spondylolysis in adolescents with back pain in a pediatric orthopaedic practice.
METHODS
A retrospective review of all patients with a diagnosis of spondylolysis who presented from January 2000 to March 2010 was performed. All patients were evaluated at a single institution by the senior author. Inclusion criteria were patients with spondylolysis confirmed on computed tomography (CT) or plain film that also received an MRI.
RESULTS
Eleven patients with spondylolysis had an MRI performed. The mean age of the study patients was 14.2 years (range 10-17). The diagnosis of spondylolysis was missed in the MRI radiology reading in 7 out of 11 (64 %) studies.
CONCLUSIONS
MRI missed a spondylolysis in over half of the adolescents in this consecutive series. In patients with a history or physical findings suggestive of spondylolysis, such as localized pain of the lumbar spine with back extension, further radiographic evaluation should be considered, even if an MRI is negative.
LEVEL OF EVIDENCE
III, retrospective review.
目的
磁共振成像（MRI）常用于评估青少年下背部疼痛。我们研究的目的是报告在一家儿科骨科诊所中，MRI漏诊青少年背痛患者脊柱裂的频率。
方法
对2000年1月至2010年3月期间所有诊断为脊柱裂的患者进行回顾性研究。所有患者均由资深作者在单一机构进行评估。纳入标准为经计算机断层扫描（CT）或平片确诊为脊柱裂且接受过MRI检查的患者。
结果
11例脊柱裂患者接受了MRI检查。研究患者的平均年龄为14.2岁（范围10 - 17岁）。在11项研究中的7项（64%）MRI影像学解读中漏诊了脊柱裂。
结论
在这个连续系列研究中，超过一半的青少年患者MRI漏诊了脊柱裂。对于有脊柱裂病史或体格检查结果提示脊柱裂的患者，如腰椎后伸时局部疼痛，即使MRI结果为阴性，也应考虑进一步的影像学评估。
证据级别
III级，回顾性研究。
Zotero 插件