目的回顾性研究极外侧型椎间 盘突出症的特征性MRI 影像表现及对临床 诊治的价值。方法 收集2013年1月-2014 年12月我院241例经手术证实的椎间盘突 出病例，其中包含63例极外侧型椎间盘 突出患者，共73处病变，根据其1.5TMRI 表现进行回顾性研究，分析其影像诊断 特征、伴发病变、好发位置与分型比例 关系，判断MRI对极外侧型椎间盘突出的 鉴别价值。结果 极外侧型椎间盘突出发 生于L4-5、L5-S1节段的比例为71.1%， 椎间孔亚型的好发比例为56.2%，伴发骨 质退变、椎间盘变性的比例高达98.4%， MRI鉴别诊断极外侧型椎间盘突出的敏感 性为75.3%，特异性为98.1%，准确性为 92.2%，阳性预测值为93.2%，阴性预测值 为92%。结论 MRI 是一种无创伤性的能准 确诊断极外侧型椎间盘突出的成像方法， 对临床的诊治工作具有重要的指导作用。

Objective To evaluate the clinical diagnostic value of the 1.5TMRI imaging characteristics of the far lateral lumbar disc herniation (FLLDH)by respective study. Methods To collect 241 cases confirmed to be protrusion of intervertebral disc by surgical operation at Luhe hospital from Jan.2013 to Dec.2014.Among these patients,63 cases are the diagnosis to be FLLDH with totally 73 lesions. According to the 1.5TMRI imaging findings of these patients, the imaging characteristics, concomitant lesions, predilection site and the relationship of typing and ratio are analyzed, thereby estimating the diagnosis value of MRI in FLLDH. Results In 73 lesions of 63 patients diagnosed to be FLLDH, 52 lesions (71.1%) are founded at L4-5 segment and L5-S1 of the spin, 41 lesions (56.2%) are the intervertebral foramen subtype. And, 68 lesions (93.2%) occurred with concomitant bone degeneration, intervertebral disc degeneration. The sensitivity of the MRI diagnostic method in FLLDH is 75.3%, the specificity is 98.1%, the accuracy is 92.2%，the negative predictive value is 93.2%，and the positive predictive value is 92%. Conclusion MRI is a noninvasive imaging method, and can accurately diagnose the far lateral lumbar disc herniation. To analyze the imaging features of FLLDH is significant for guiding clinical diagnosis and treatment.