高娜　赵汝莲

[摘要] 目的 旨在比较分析CT与MRI在腰椎间盘突出症诊断中的应用价值。 方法 选择2015年1月～2016年1月间我院住院接受治疗的40例腰椎间盘突出症患者，患者及其家属均自愿签署知情同意书，所有患者均接受CT、MRI检查。 结果 40例腰椎间盘突出症患者中，CT检查显示：髓核出现钙化斑点24例，硬膜囊受压16例，出现积气29例，神经根受压13例，其中单侧受压 8例，双侧受压5例。而MRI检查显示：38例出现椎间盘变性，硬膜囊受压26例，神经根受压18例，其中单侧受压 12例，双侧受压6例；脊髓变性12例。CT与MRI检查在椎间盘变性、钙化、硬膜囊受压、积气及神经根受压、脊髓变性方面比较，差异具有统计学意义（P<0.05）。 结论 CT、MRI均在腰椎间盘突出症诊断中具有重要价值。其中，CT 能够直观地反映患者椎间盘突出及脊髓、硬膜囊压迫情况，但无法观察椎间隙其他结构。MRI在软组织的探查中辨识度较高，能够清晰有效地显示髓核及神经情况。

[关键词] 腰椎间盘突出症；CT检查；MRI检查；应用价值

[中图分类号] R681.53；R816.8；R445.2 [文献标识码] B [文章编号] 1673-9701（2017）23-0099-03

[Abstract] Objective To compare and analyze the application value of CT and MRI in the diagnosis of lumbar disc herniation. Methods 40 patients with lumbar disc herniation who were hospitalized in our hospital and were given the treatment from January 2015 to January 2016 were selected. Patients and their families were willing to sign the informed consent. All patients were given the examinations of CT and MRI. Results Among the 40 patients with lumbar disc herniation， CT examination showed： calcification spots were observed in nucleus pulposus in 24 cases， dural sac compression in 16 cases， gas in 29 cases， nerve root compression in 13 cases， including 8 cases of unilateral compression and 5 cases of bilateral compression. The MRI examination showed： disc degeneration in 38 cases， dural sac compression in 26 cases， nerve root compression in 18 cases， including unilateral compression in 12 cases and bilateral compression in 6 cases； there were 12 cases of spinal cord degeneration. The differences in the disc degeneration， calcification， dural sac compression， gas and nerve root compression， and spinal cord degeneration compared between the CT and MRI examinations were significant（P<0.05）. Conclusion CT and MRI are of great value in the diagnosis of lumbar disc herniation. Among them， CT can intuitively reflect the patients' disc herniation and spinal cord and dural sac compression， but can not observe the other structures of the intervertebral space. MRI has a high degree of recognition in the detection of soft tissues， which can clearly and effectively show the nucleus pulposus and nerve conditions.

[Key words] Lumbar disc herniation； CT examination； MRI examination； Application value

腰椎間盘突出症（lumbar disc herniation，LDH）是一种常见的退行性病变，是骨科临床的常见病、多发病，患者多会伴有一侧或双侧下肢疼痛、麻木、腰部疼痛等症状，严重影响患者的生活质量[1]。腰椎间盘突出的诊断临床多通过腰椎X线平片、CT及MRI检查和其他电生理检查以及结合病史和其他查体结果等确定[2]。CT和 MRI检查为常用两种检查方式，各有优劣。本研究旨在比较CT与MRI在腰椎间盘突出症诊断中的应用价值，现报道如下。

1 资料与方法

1.1一般资料

选择2015年1月～2016年1月间在我院住院接受治疗的40例腰椎间盘突出症患者，患者及其家属均自愿签署知情同意书，排除肝肾功能不全、心脑血管疾病、血液系统疾病及其他禁忌证者。年龄22～70岁，平均（45.1±11.3）岁；病程1～12年，平均（7.1±3.2）年。……