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腰腿痛的CT及MRI诊断分析

作者:梁煜坤

所属单位:陕西省安康市中心医院影像中心(陕西 安康 725000)

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摘要

目的 分析CT与MRI诊断腰腿痛 的影像学特点并比较两种检查方法在腰 腿痛病因明确方面的临床价值。方法 选 择我院2013年10月-2015年10月期间收 治66例因腰腿痛就诊的患者作为研究对 象,所有患者均予以CT检查与MRI检查, 分析影像学表现并明确病因。结果 CT与 MRI检查发现患者腰腿痛主要原因包括 椎间盘膨大与突出、腰椎退变(增生及 疏松)、椎间盘变性、椎管狭窄、腰椎 滑脱、终板炎(许莫结节)、腰椎(管)肿 瘤、腰肌劳损等,其中MRI检查对椎间 盘变性、腰肌劳损的确诊率高于CT,差 异有统计学意义(P<0.05)。结论 CT 与MRI在腰腿痛临床诊断中均有较大应用 价值,其中CT由于扫描范围有限,检查 层面不同,脊髓肿瘤漏诊误诊可能性较 大,对终板炎、腰椎退变、椎体肿瘤所 引起疼痛的显示不如MRI,因而可将MRI 作为首选检查方法,若医院无MRI设备, 也可将CT作为替代方法。

Objective To analyze the imaging characteristics of CT and MRI in the diagnosis of lumbocrural pain and to compare the clinical value of the two kinds of examination methods in determination of the causes of lumbocrural pain. Methods 66 patients with lumbocrural pain treated in our hospital from October 2013 to October 2015 were treated as the research objects. All patients were examined with CT and MRI. The imaging findings were analyzed and the causes were determined. Results CT and MRI examination found that the main causes of lumbocrural pain in patients included intervertebral disc intamescentia and extrusion, degeneration of the lumbar spine column (hyperplasia and osteoporosis), intervertebral disc degeneration, spinal stenosis, spondylolisthesis, endplate inflammation (Schmorl nodes), lumbar (tube) tumor and lumbar muscle strain, etc.. The confirmed diagnosis rates of MRI examination of intervertebral disc degeneration and lumbar muscle strain were higher than those of CT (P<0.05). Conclusion CT and MRI in the clinical diagnosis of lumbocrural pain has great application value, of which due to the limited scope of scanning and different examination levels, the possibility of CT in missed diagnosis and misdiagnosis of spinal cord tumor is larger. The display of pain induced by endplate inflammation, degeneration of the lumbar spine column and vertebral tumors is not as good as MRI, thus MRI is the preferred method of inspection. If there is no MRI equipment in the hospital, CT can be taken as an alternative method.

【关键词】腰腿痛;CT;MRI;病因;影像学表现

【中图分类号】R323.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.05.038

前言

腰腿痛为腰部或腿部疼痛疾病的总称,患者往往病因复杂,且 症候反复发作,致使工作与生活受到较大不利影响,生活质量因此 降低[1]。为采取针对性治疗方案,明确患者病因成为首要问题。CT与 MRI均为临床常用影像学检查方法,也腰腿痛患者临床诊断中也较为 常用。为比较两种检查方法在腰腿痛患者中诊断价值,本研究以我院 2013年10月~2015年10月期间收治66例因腰腿痛就诊患者为例,分析 CT与MRI诊断腰腿痛的影像学特点并比较两种检查方法在腰腿痛病因明 确方面的临床价值,现报道如下。