MRI和CT椎间盘造影对腰椎间盘破裂诊断的比较研究

目的 比较MRI、CT椎间盘造影（CTD）对腰椎间盘破裂的诊断价值。方法 选择有慢性下腰痛病史、无典型的神经根性症状和体征、CT平扫和MR检查无腰椎间盘突出征象的16例患者行MR和CTD配对检查；制定统一的CTD分型及阳性椎间盘的标准；观察诱发腰痛与椎间盘内注射对比剂剂量之间的关系。结果 16例（21个腰椎间盘）MR和CTD的配对检查，CTD显示12个腰椎间盘为2型、1个腰椎间盘为5型，合计13个为阳性椎间盘，MRI显示6个腰椎间盘纤维环后方可见高信号区，为椎间盘破裂的间接征象，7个腰椎间盘仅显示退行性改变。结论 CTD是显示椎间盘破裂直接征象的惟一方法；诱发腰痛与腰椎间盘破裂类型有关。常规MRI仅能显示部分腰椎间盘破裂的间接征象，要明确腰椎间盘破裂需行CTD。

The comparative study of lumbar disc disruption with MRI and CT discography

Objective To compare MRI wi th CT discography (CTD) for diagnostic assessment of lumbar disc disruption. Methods Paired comparative examination in 16 patients with ch ronic lower back pain without radicular pain and no disc herniation was conducte d using CT or MRI. The standard of CTD classification and positive disc was for mulated and the correlation between the induced lower back pain and dosage used in CTD was observed. Results For a total of 21 discs in the 16 patients, CTD showed the disc as type 2 in 12 discs and type 5 in 1 disc with 13 positive discs, while MRI only showed the high-intensity zone of poster ior annulus in 6 discs as the indirect sign of disc disruption and disc degenera tion in 7 discs. Conclusion CTD was the only method for showing the direct sign of disc disruption. The induced lower back pain was rel ated with the type of disc disruption. MRI can show some of the indirect signs of disc disruption and CTD can show the direct sign of disc disruption.