Lumbar Disc High‐intensity Zone: Correlation of Magnetic Resonance Imaging and Discography
Lumbar Disc High‐intensity Zone: Correlation of Magnetic Resonance Imaging and Discography
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DOI：
10.1097/00007632-199601010-00018
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发表时间：
1996-01
期刊：
影响因子：
3
通讯作者：
K. Schellhas;S. Pollei;C. Gundry;K. Heithoff
中科院分区：
文献类型：
--
作者：
K. Schellhas;S. Pollei;C. Gundry;K. Heithoff
研究设计。这项研究将一种特定的腰椎间盘异常（描述为高场磁共振成像上观察到的高强度区域）与椎间盘造影相关联。目标。分析有症状的腰痛/神经根痛患者腰椎间盘高强度区的意义。背景数据摘要。 Aprill 和 Bogduk 描述了在对背痛患者进行的 T2 加权磁共振成像研究中，腰椎间盘出现一致疼痛的椎间盘造影的发生率为 86%，显示出后部高强度区。他们断言，高强度区是有症状受试者椎间盘源性疼痛的可靠标志。方法。对有症状的患者使用 T2 加权图像进行腰椎高场磁共振成像，然后对所有高强度区水平和非高强度区对照水平进行椎间盘造影进行回顾，直到在 63 名患者中发现 100 个高强度区椎间盘。十七名终生无症状（腰痛/神经根痛）的成年人也接受了扫描，作为磁共振成像对照。所有磁共振扫描和椎间盘图均得到至少两名放射科医生作者的同意。结果。 100 个高强度区域椎间盘中有 87 个在椎间盘造影时显示出一致的疼痛。所有 87 个疼痛且一致的椎间盘均表现出异常形态，环状撕裂延伸至或穿过纤维环的外三分之一。 67 个非高强度区域控制盘中有 65 个不协调且感觉强度低于高强度区域盘。在对照组中仅发现一个高强度区域。结论。对于有症状的腰痛患者，高强度区是疼痛性外环破裂的可靠标志。
Study Design. This study correlated a specific lumbar disc abnormality described as the high‐intensity zone observed on high‐field magnetic resonance imaging with discography. Objectives. To analyze the significance of high‐intensity zones in lumbar discs of symptomatic patients with low back/radicular pain. Summary of Background Data. Aprill and Bogduk described an 86% incidence of concordantly painful discography in lumbar discs exhibiting a posterior high‐intensity zone on T2‐weighted magnetic resonance imaging studies performed on back pain sufferers. They assert that the high‐intensity zone is a reliable marker of discogenic pain in symptomatic subjects. Methods. Consecutive cases of lumbar spine high‐field magnetic resonance imaging using T2‐weighted images on symptomatic patients followed by discography at all high‐intensity zone levels and at non‐high‐intensity zone control levels were reviewed until 100 high‐intensity zone discs in 63 patients were found. Seventeen lifelong asymptomatic (for low back/radicular pain) adults were also scanned as magnetic resonance imaging controls. All magnetic resonance scans and discograms were agreed on by at least two of the radiologist authors. Results. Eighty‐seven of 100 of the high‐intensity zone discs proved concordantly painful at discography. All 87 painful and concordant discs exhibited abnormal morphology with anular tears extending either well into or through the outer third of the anulus fibrosus. Sixtyfive of 67 non‐high‐intensity zone control discs were nonconcordant and of lower sensation intensity than the high‐intensity zone discs. Only one high‐intensity zone was found in the control subjects. Conclusions. In patients with symptomatic low back pain, the high‐intensity zone is a reliable marker of painful outer anular disruption.