Pusan National University School of Medicine, Busan, Republic of Korea; Department of Neurosurgery, Pusan National University Hospital, Biomedical Research Institute, Busan, Republic of Korea.
Pusan National University School of Medicine, Busan, Republic of Korea; Department of Radiology, Pusan National University Hospital, Biomedical Research Institute, Busan, Republic of Korea.
Eur J Radiol. 2021 Apr;137:109569. doi: 10.1016/j.ejrad.2021.109569. Epub 2021 Jan 27.
To compare the computed tomography (CT) and magnetic resonance imaging (MRI) findings of lumbar intradural disc herniation (IDH) and disc extrusion mimicking IDH.
Between January 2015 and August 2018, 32 with surgically confirmed IDH or disc extrusion mimicking IDH were included. Age, sex, symptoms, herniated disc level, history of discectomy at the same site, and operative findings were investigated through the medical records. We evaluated the direction, type, migration, margin, and shape of disc herniation, the presence of an abrupt discontinuity of the posterior longitudinal ligament (PLL), Y-sign of ventral dura, disc material beyond the PLL, and disc calcification or ossification. In addition, maximum herniated disc diameter to central canal diameter (MHDD/CCD) ratios were calculated.
Twelve patients (8 males, 4 females; mean age 53.3 [21-83] years) were surgically confirmed to have lumbar IDH and 20 (11 males, 9 females; mean age 52 [19-78] years) had disc extrusion mimicking lumbar IDH. Margins and beak-like shapes of herniated discs, abrupt discontinuity of the PLL, Y-sign of ventral dura, disc material beyond the PLL, calcification or ossification of herniated discs, and MHDD/CCD ratios were significantly different in the IDH and non-IDH groups (p < 0.05).
Imaging findings of an ill-defined margin, a beak-like shape, herniated disc calcification or ossification, abrupt PLL discontinuity, Y-sign of ventral dura, disc material beyond the PLL and a high MHDD/CCD ratio were found to predict the presence of IDH.
比较腰椎硬脊膜内椎间盘突出症（IDH）与酷似 IDH 的椎间盘突出的 CT 和 MRI 表现。
回顾性分析 2015 年 1 月至 2018 年 8 月间 32 例经手术证实的 IDH 或酷似 IDH 的椎间盘突出患者的资料。通过病历调查患者的年龄、性别、症状、椎间盘突出水平、同一部位椎间盘切除术史及手术所见。评估椎间盘突出的方向、类型、迁移、边缘和形状、后纵韧带（PLL）的突然中断、腹侧硬脑膜的 Y 征、PLL 以外的椎间盘物质及椎间盘钙化或骨化。另外，还计算了最大椎间盘突出直径与中央椎管直径（MHDD/CCD）的比值。
12 例（8 男 4 女；平均年龄 53.3 [21-83] 岁）患者经手术证实为腰椎 IDH，20 例（11 男 9 女；平均年龄 52 [19-78] 岁）患者为酷似 IDH 的椎间盘突出。IDH 组与非 IDH 组的椎间盘突出边缘不规则、喙状形状、椎间盘钙化或骨化、PLL 突然中断、腹侧硬脑膜的 Y 征、PLL 以外的椎间盘物质、钙化或骨化及 MHDD/CCD 比值均有显著差异（p<0.05）。
边界不清晰、喙状形状、椎间盘钙化或骨化、PLL 突然中断、腹侧硬脑膜的 Y 征、PLL 以外的椎间盘物质、MHDD/CCD 比值较高等影像学表现提示 IDH 的存在。
