张洛峰

[摘要] 目的 探究腰椎間盘突出患者采用MRI以及CT检查作用和影像学表现。方法 方便选择在该院进行腰椎间盘突出检查的88例患者为研究样本，其检查时间均在2018年1— 12月之间，全部患者均同时进行MRI以及CT检查，检查结果均提示为腰椎间盘突出，通过对88例患者临床资料进行回顾性分析，以病理检查结果作为判断其准确性的唯一标准，观察两种治疗方式诊断准确性和影像学情况。结果 在MRI检查结果中腰椎间盘突出诊断阳性率为76例（86.36%），阴性率是12例（13.64%），阴性结果中包含3例漏诊以及9例误诊;在CT检查结果中腰椎间盘突出诊断阳性率为73例（82.95%），阴性率是15例（17.05%），阴性结果中包含5例漏诊以及10例误诊，两种检查方式在准确性方面比较差异无统计学意义（χ2=0.448，P>0.05）。CT检查在椎间盘积气以及椎间盘钙化方面诊断准确性高于MRI检查，在硬膜囊受压、脊髓受压以及椎间盘变形方面诊断准确性低于MRI检查（χ2=18.867、12.516、4.812、21.863、27.596，P<0.05），但CT检查与MRI检查在神经受压方面诊断准确性比较差异无统计学意义（χ2=0.737，P>0.05）。结论在腰椎间盘突出检查中MRI检查以及CT检查均具有较高的诊断价值，并且MRI检查针对椎管狭窄以及受压情况具有较高的诊断准确性，将两种检查方式联合应用于临床腰椎间盘突出检查，可一定程度上提升检查准确性。

[关键词] 影像学特征;腰椎间盘突出症;CT;MRI

[Abstract] Objective To study the clinical value of imaging characteristics of MRI （magnetic resonance imaging） and CT （computed tomography） in lumbar intervertebral disc herniation. Methods Convenient select The clinical data about 88 lumbar intervertebral disc herniation patients checked from January to December 2018 in our hospital was retrospectively analyzed. MRI and CT was performed. The pathological examination results were seen as the sole criteria of lumbar intervertebral disc herniation. The diagnosis accuracy and imaging characteristics were recorded. Results The positive and negative diagnosis rate of lumbar intervertebral disc herniation based on MRI was 76 cases 86.36% and 12 cases 13.64%， including 3 missed diagnosis cases and 9 misdiagnosis cases. The positive and negative diagnosis rate of lumbar intervertebral disc herniation based on CT was 73 cases 82.95% and 15 cases 17.05%， including 5 missed diagnosis cases and 10 misdiagnosis cases. The diagnosis accuracy based on MRI and CT was not significantly different （χ2=0.448，P>0.05）; the diagnosis accuracy of intervertebral pneumatosis and calcification based on CT was higher than MRI; the diagnosis accuracy of dural sac compression， spinal cord compression and intervertebral transformation based on CT was lower than those of MRI （χ2=18.867， 12.516， 4.812， 21.863，27.596，P<0.05）; the diagnosis accuracy of nerve compression based on CT and MRI was not significantly different （χ2=0.737，P>0.05）. Conclusion Both of MRI and CT has high diagnostic value of lumbar intervertebral disc herniation. However， the diagnosis accuracy of spinal stenosis and compression based on MRI is higher. Therefore， the combination of MRI and CT can increase the diagnosis accuracy of lumbar intervertebral disc herniation.

[Keywords] Imaging characteristics; Lumbar intervertebral disc herniation; CT; MRI

腰椎间盘突出症在临床疾病中较为常见，其主要是由于腰椎间盘各组织出现退行性变化，并且长期在外力作用下导致椎间盘纤维环破裂，从而引起髓核由破裂位置向外突出，对周围神经产生压迫，导致出现腰部疼痛情况[1]。第四……