红外热像图在腰椎间盘突出症中辅助诊断价值的探讨

目的 该研究旨在探讨远红外热像图在椎间盘突出症（LDH）辅助诊断中的价值。方法对疼痛门诊中自诉腰痛并单侧下肢痛放射性疼痛的病人23例，随机进行红外热像图测定，并接受CT断层扫描检查。观察和分析腰骶部及下肢热形态、兴趣区域的温度及双下肢对应部位的温度差异（△T），并分析F—IRT诊断LDH灵敏度和特异性。结果 F—IRT显示：23例LDH患者腰骶部热形态改变为四种形式：梭形，热区向一侧偏歪或呈角状突起（8例）；脊中线热区不连贯（6例）；骶髂骨土缘呈大片高温热区（5例）；不规则形态（4例），患侧下肢较相对应的对侧肢体的温度，至少有一个患侧部位出现温度下降的有19例（82．61％），综合CT与F—IRT结果分析：F—IRT诊断腰椎间盘侧后突的灵敏度为90．48％，特异度为66．68％。但患侧的热区分布与椎间盘突出部位并没有明显的相关性。结论 F—IRT检查能较为精确地反映自主神经系统改变引起的体表温度的改变，在LDH的辅助诊断中有一定的价值，但尚不能进行病变椎间盘的定位。

Far-infrared thermography in the diagnosis of lumbar disc herniation

[Objective] To evaluate the role of far-infrared thermography in the diagnostic function on lumbar disc herniation (LDH). [Methods] Our study included twenty-seven patients who complained of the repetitive pain on their low back and only unilateral lower limb. They were examined with far-infrared thermography, then taken computed tomography scan (CT). The characteristics of thermographic images were analysed, including the patterns of thermogram on low back, the thermal differences between the normal and complained limbs or hips or lumbar sacroiliac area. The sensitivity and specificity of far-infrared thermography in the diagnosis of lumbar disc herniation were evaluated. [Results] Compared with the normal, the thermogram of twenty-three cases on low back with LDH changed. They can be divided into four thermal patterns that is shuttle-liking (8 cases), discontinued in the middle line (6 cases), large regional (5 cases) and nonregular (4 cases) pattern. The temperature of abnormal sides is lower than the counterpart in most cases (nineteen of twenty-three). The thermography diagnosed LDH with sensitivity 90.48% and specificity 66.68%. But abnormal thermal distribution has no corresponding relation with the location of herniated disc. [Conclusion] The far-infrared thermography could reflect abnormal functional changes on complained limbs with LDH by examining the temperature, but it can not localize herniated lumbar disc.