磁共振成像在鉴别腰椎间盘韧带下型与韧带上方型突出中的价值。
The value of MR in differentiating subligamentous from supraligamentous lumbar disk herniations.
作者信息
Silverman C S, Lenchik L, Shimkin P M, Lipow K L
机构信息
Department of Radiology, Bridgeport Conn. Hospital 06610, USA.
出版信息
AJNR Am J Neuroradiol. 1995 Mar;16(3):571-9.
PURPOSE
To determine the value of MR criteria in differentiating subligamentous from supraligamentous lumbar disk herniations.
METHODS
A retrospective review of surgical reports and MR images of 50 patients undergoing first-time lumbar surgery was performed. Three MR imaging criteria were assessed: the presence and integrity of a low-signal-intensity line posterior to the disk herniation, the size of the disk herniation in comparison with the size of the spinal canal, and the presence of disk fragments. Correlation was made with surgical findings to determine the value of these MR criteria in differentiating subligamentous from supraligamentous disk herniations.
RESULTS
For determining subligamentous disk herniations: the presence of a continuous low-signal-intensity line posterior to the disk herniation was 29% sensitive, 65% specific, and 42% accurate; disk herniation size less than 50% of the size of the spinal canal was 64% sensitive, 47% specific, and 58% accurate; and the absence of disk fragments was 88% sensitive, 12% specific, and 62% accurate. Combinations of individual MR criteria did not improve diagnostic accuracy.
CONCLUSIONS
For differentiating subligamentous from supraligamentous lumbar disk herniations, none of the MR imaging criteria assessed was reliable.
目的
确定磁共振成像（MR）标准在鉴别腰椎间盘韧带下型与韧带外型突出中的价值。
方法
对50例首次接受腰椎手术患者的手术报告和MR图像进行回顾性分析。评估了三项MR成像标准：椎间盘突出后方低信号强度线的存在及完整性、椎间盘突出大小与椎管大小的比较、椎间盘碎片的存在情况。将这些标准与手术结果进行相关性分析，以确定其在鉴别韧带下型与韧带外型椎间盘突出中的价值。
结果
对于确定韧带下型椎间盘突出：椎间盘突出后方存在连续低信号强度线，敏感度为29%，特异度为65%，准确率为42%；椎间盘突出大小小于椎管大小的50%，敏感度为64%，特异度为47%，准确率为58%；无椎间盘碎片，敏感度为88%，特异度为12%，准确率为62%。单个MR标准的组合并未提高诊断准确性。
结论
对于鉴别腰椎间盘韧带下型与韧带外型突出，所评估的MR成像标准均不可靠。
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