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目的应用磁共振三维短恢复时间反转恢复(3D-STIR)序列磁共振神经成像(MRN)诊断旁侧型腰椎间盘脱出,并与手术分型对比观察。方法回顾性分析24例旁侧型腰椎间盘脱出病例的影像学资料和临床资料,将术前MRN所示按脱出髓核组织与受累神经根的位置关系分为肩型、腋型和根型,总结MRN所示不同水平各型椎间盘脱出卡压神经根的情况,并将术前MRN表现与手术所见的3种分型进行比较。结果 24例患者共25处椎间盘脱出,集中在L_3~S_1椎间盘水平。3D-STIR增强扫描示肩型、腋型及根型脱出分别为3处、7处和15处,80%(20/25)的脱出累及下一椎体神经根,其中腋型脱出多累及两根神经根(71.4%,5/7)。术前MRN与手术分型有较好的一致性(Kappa值=0.865,P<0.01)。结论 3D-STIR MRN可对腰椎间盘脱出卡压的神经根进行具体且全面的评估,与术中手术分型一致性较高,对患者的术前评估、手术方案制定、术后并发症的预防具有重要的指导意义。
Objective To investigate the diagnosis of lateral lumbar intervertebral disc prolapse with 3D-STIR magnetic resonance neuroimaging (MRN). Methods The imaging data and clinical data of 24 cases of prolapse of lateral lumbar disc were retrospectively analyzed. According to the preoperative MRN, the relationship between the location of nucleus pulposus and the nerve root was divided into shoulder type, axillary type and root type. Summarize the different types of MRN showed various types of disc prolapse compression nerve root conditions, and preoperative MRN performance and surgical findings of the three types of comparison. Results Twenty-five patients underwent a total of 25 disc herniations, concentrating on the L_3 ~ S_1 intervertebral disc. 3D-STIR enhanced scan showed shoulder, axillary and root prolapse were 3, 7 and 15, 80% (20/25) of the prolapse involving the next vertebral root, in which axillary prolapse involving two Roots (71.4%, 5/7). There was a good agreement between preoperative MRN and surgical classification (Kappa = 0.865, P <0.01). Conclusion The 3D-STIR MRN can evaluate the nerve root compression of prolapse of lumbar intervertebral disc specifically and comprehensively, which is consistent with the intraoperative classification of the operation. The preoperative assessment, surgical plan formulation and postoperative complication prevention It has important guiding significance.