摘要
目的探讨磁共振脊髓造影(MRM)在腰椎间盘突出症(PLID)神经根受压中的诊断价值。资料与方法连续观察行MRI检查的52例有单个神经根受压症状和体征的PLID患者,分别用MRI和MRM诊断责任病变椎间盘,评价二者与临床诊断的一致性及诊断准确性。结果 MRI诊断结果与临床诊断一致性差(Kappa=0.36),MRM诊断结果与临床诊断一致性好(Kappa=0.85)。以临床定位诊断作为标准,MRM诊断神经根受压的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为92.3%、98.1%、96.0%、96.2%、96.2%,而MRI诊断神经根受压的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为82.7%、79.8%、67.2%、90.2%、80.8%。MRM诊断神经根受压的特异度、阳性预测值、阴性预测值和准确度均明显高于MRI(χ2=26.23,P<0.05);敏感度高于MRI,但二者差异无统计学意义(χ2=0.68,P>0.05)。结论 MRM在PLID患者责任病变椎间盘的确认和排除上优于MRI,是常规MRI检查的有益补充。
Purpose To evaluate the value of MRM in the diagnosis of nerve roots compression in prolapse of lumbar intervertebral disc （PLID）. Materials and Methods A successive observation was conducted to 52 patients with PLID and with the symptoms of unilateral nerve roots compression. Diagnosis of the intervertebral disc lesions was made by using MRI and MRM, respectively. The consistency and diagnosability between these two examinations and clinical diagnosis were evaluated. Results The consistence between the clinical diagnosis and MR1 diagnosis was poor （Kappa = 0.36）, but which was good between MRM and clinical diagnosis （Kappa =0.85）. According to clinical orientation standards, diagnosis of nerve roots compression by MRM was significantly better than MRI in specificity, positive predictive value, negative predictive value and accuracy （P 〈 0.05）. Sensitivity of MRM was also higher than MRI, but the difference was not statistic （P〉O.05）. Conclusion MRM has a great value and is superior to MRI for patients with PLID in identificationand exclusion the lesion of intervertebral disc. MRM can be used as one of the routine diagnosis method of PLID in clinic.
出处
《中国医学影像学杂志》
CSCD
北大核心
2011年第8期575-579,共5页
Chinese Journal of Medical Imaging
关键词
腰椎
脊椎滑脱
磁共振成像
脊髓造影术
Lumber vertebrae
Spondylolysis
Magnetic resonance imaging Myelography
