摘要
目的探讨CT引导下椎间盘造影的临床应用价值。方法回顾性分析55例慢性腰痛或腰腿痛患者的CT引导下椎间盘造影表现及临床资料,依据对比剂在椎间盘内、外的弥散范围,对椎间盘破裂、椎间盘退行性变及椎间盘退行性变合并椎间盘破裂进行分级。结果 55例中,2例穿刺失败,53例造影成功。造影椎间盘132个;根据达拉斯CT椎间盘造影评价法,51个椎间盘形态正常,81个椎间盘形态异常。阳性椎间盘73个,其中椎间盘纤维环撕裂30个,包括Ⅰ级3个、Ⅱ级15个、Ⅲ级12个,椎间盘纤维环退行性变24个,包括Ⅰ级2个、Ⅱ级12个、Ⅲ级10个,椎间盘退行性变并合椎间盘破裂19个。CT引导下椎间盘造影同时可激发再现原有腰痛或腰腿痛,证实腰痛或腰腿痛的病因。结论依据CT引导下椎间盘造影表现可准确对椎间盘退行性变和破裂程度及椎间盘退行性变合并破裂进行分级,有助于临床诊断和治疗。
Objective To assess clinical value of CT-guided discography. Methods CT findings in 55 patients with chronicity lumbodynia or backleg pain who underwent CT-guided discography were retrospectively analyzed. According to the extent of contrast medium in exterior and interior intervertebral discs, classifications of disrupt of intervertebral discs, degeneration of annular fibrosus and degeneration complicating ruptured intervertebral disc were performed. Results Puncture failed in 2 patients. CT-guided discography was performed successfully for 132 intervertebral discs in 53 patients underwent. These intervertebral discs were classified according to Dallas discogram description （DDD）. Fifty-one intervertebral discs were normal （0 class）, while 81 discs were abnormal. There were 30 ruptured intervertebral discs, including 3 with Ⅰ degree, 15 with Ⅱ degree and 12 with Ⅲ degree ruptures. Degenerations were found in 24 intervertebral discs, including 2 with Ⅰ degree discs, 12 with Ⅱ degree and 10 with 3 Ⅲ degree degeneration. Degeneration complicated with rupture were detected in 19 intervertebral discs. At the same time, CT-guided discography might stimulate and playback intrinsical lumbodynia or backleg pain, so as to confirm the cause of intrinsical lumbodynia or backleg pain. Conclusion CT-guided discography contributes to clinical diagnosis and treatment via classification of ruptured discs, degenerations of annular fibrosus and degeneration complicated with rupture of intervertebral discs.
出处
《中国介入影像与治疗学》
CSCD
2014年第4期209-212,共4页
Chinese Journal of Interventional Imaging and Therapy
