腰椎间盘突出症神经根受压MRM与临床表现的相关性研究

目的探讨腰椎间盘突出症(PLID)磁共振脊髓造影(MRM)神经根受压轻重与临床表现轻重的相关性。方法连续观察行MRM检查的48例有单个神经根受压症状和体征的PLID患者,按MRM表现将神经根受压轻重分两组,轻组:神经根袖信号减弱但轮廓完整;重组:神经根袖信号部分或全部缺失,轮廓中断或消失。将直腿抬高试验≤30°、有神经根损害征象(肌力减退、腱反射减弱或消失和肌萎缩3项中出现任意一项)及间歇性跛行3项中出现任意一项者,诊断为临床表现重;未出现者诊断为临床表现轻。比较MRM表现神经根受压轻重与临床表现轻重的一致性。结果48例患者中MRM神经根受压轻重与临床表现轻重一致性好(Kappa=0.653),MRM神经根受压轻重与直腿抬高角度及间歇性跛行的有无一致性好(Kappa值分别为0529和0.747);MRM神经根受压轻重与有无神经根损害一致性差(Kappa=0.324)。结论MRM显示的PLID神经根受压程度与临床表现轻重程度有很好的一致性,这有助于更好地解释临床并获得影像学依据,是常规MRI检查的有益补充。

Relationship between the degree of nerve roots compression in magnetic resonance myelography and the severity of clinical symptom in prolapse of lumbar intervertebral disc

Objective To evaluate the value of MRM in the diagnosis of nerve roots compression in prolapse of lumbar intervertebral disc(PLID).Methods A successive observation of 48 patients with PLID and the symptoms of single nerve roots compression was conducted,two groups were divided in according to the degree of nerve roots compression.The lighter group was with weaken signal of nerve root axis but whole outline.The severe group was with part or whole disappear of nerve root axis and interrupted or disappear outline.The degree of clinical symptoms were according to straight leg raising test(≤30°),symptoms of nerve root damage and intermittent limp.Compare the consistency between degree of nerve root compression in MRM and degree of clinical symptoms.Results The Kappa value between the clinical diagnosis and MRM was 0.653,the Kappa value between MRM and straight leg raising test and clinical symptoms was 0.529 and 0.747 respectively.The Kappa value between degree of nerve root compression and nerve root damage was 0.324.Conclusion MRM has a great value for patients with PLID and is superior to MRI.Therefore,MRM can be used as the routine supplement for diagnosis of PLID in clinic.