腰椎管内椎间盘游离髓核的MRI表现及诊断价值

目的 探讨腰椎管内椎间盘游离髓核MRI表现及诊断价值.方法 回顾性分析46例腰椎管内椎间盘游离髓核患者MRI征像,并与手术病理结果进行比较.结果 46例腰椎管内游离髓核均位于硬膜外间隙前部.游离髓核在椎管内向上游走9例,向下游走32例,向后水平游走5例;占据右隔区22例,左隔区17例,中线隔区7例.46例均为单发病灶,其形态呈圆形、卵圆形及片带状不规则形.游离髓核与供体椎间盘髓核呈等或稍低信号,当有钙化时,呈低信号灶.其中11例行GD-DTPA对比剂增强扫描,病灶中心均无强化表现,边缘均有环形中、高度强化.46例腰椎管内椎间盘游离髓核的MRI诊断与手术病理结果全部相符,诊断符合率达100%.结论 MRI对腰椎管内游离髓核能作出正确诊断,是椎间盘病变首选的检查方法.

MRI findings and diagnostic value of intervertebral disc free pulpiform nucleus in lumbar intraspinal

Objective To determine the MRI findings and diagnostic value of intervertebral disc free pulpiform nucleus in lumbar intraspinal. Methods MRI findings of 46 cases with free pulpiform nucleus proved by surgery and pathology were retrospectively analyzed, and compared with pathological results. Results Of all cases, the free pulpiform nucleus located at extradural foreside. 9 cases of the free pulpiform nucleus dissociated upon in spinal, 32 cases moved down and 5 cases removed backwards. Of 46 patients, 22 cases of the free pulpiform nucleus inhabited right, 17 cases left and 7 cases in midline. The lesion was single in all case with round, oval or anormaly shape. The free pulpiform nucleus had the same equal or low signal with provided intervertebral disc. The calcification, if any, presented as low -signal area. Among these 11 cases which were injected with GD-DTPA had no enhancement in the center, mild and high enhancement at periphery. Among all cases, MRI diagnosis were agreed with the pathology results with diagnostic accuracy of 100%. Conclusion MRI can clearly demonstrate the intervertebral disc free pulpiform nucleus in lumbar intraspinal and make a correct diagnosis. Therefore, MRI is the best choice for diagnosis of intervertebral disc free pulpiform nucleus in lumbar intraspinal.