腰椎间盘突出症不同病理学分型的椎间盘造影表现

目的：探讨椎间盘造影术在腰椎间盘突出症的不同病理类型中的表现及意义.方法：对在我院接受手术治疗的43例腰椎盘突出症患者术中进行椎间盘造影,并摄片;观察不同病理学类型的造影结果.结果：不同病理类型的腰椎间盘突出症有不同的造影表现.（1）椎体后缘骨软骨病造影显示髓核形态基本正常,侧位片上呈现圆形、椭圆形或马蹄形,比较饱满.可伴有发育不良的表现.（2）退变型腰椎间盘突出造影显示分散状或多支状影像,造影剂呈弥漫分布,扁平而扩大,几乎充盈整个椎间盘.（3）破碎型腰椎间盘突出造影显示阴影向后延伸,有时达椎体后缘或者后纵韧带,甚至进入椎管.（4）椎体后缘骨软骨病基础上的间盘疝出造影显示髓核显影饱满,呈现椭圆形或马蹄形,同时伴有向后突出的阴影.结论：腰椎间盘突出症的不同病理类型有特异的椎间盘造影表现,椎间盘造影在病理分型中有重要意义.

Study on Discography in Different Pathological Types of Lumbar Disc Herniation

Objective: To study the significance of discography in different pathological types of lumbar disc herniation. Methods: Forty-three patients with lumbar disc herniation (LDH) were given discography during discectomy, and taken X ray film. The relationship between discograms and the different pathological types of LDH was analyzed. Results: There were different discograms of different pathological types of LDH. (1) The discograms showed that the shape of nucleus pulposus was normal such as round, ovary or C form, and the shape was well-stacked in patients with osteochondrosis of posterior vertebral edge. Some patients combined with dysplasia. (2) The discograms showed that the shape of image was diffusing or multi-branching, and the contrast medium was diffusing, flat and large, filling the whole intervertebral space in patients with degenerative LDH. (3) The discograms showed that the contrast extended backward, reached the posterior edge of vertebrae or posterior longitudinal ligament, or even got into the vertebral canal in the patients with ruptured LDH (RDH). (4) The discograms showed that the nucleus pulposus was well-stacked such as ovary or C form, and bulging image also existed in patients with RDH in osteochondrosis of posterior vertebral edge. Conclusion: Different pathological types of LDH have specific discograms, and discography has a significant role in the pathological classification of lumbar disc herniation.