Missed cervical disc bulges diagnosed with kinematic magnetic resonance imaging
Missed cervical disc bulges diagnosed with kinematic magnetic resonance imaging
复制标题
通过运动磁共振成像诊断漏诊的颈椎间盘突出
DOI：
10.1007/s00586-014-3385-9
复制
发表时间：
2014-08-01
影响因子：
2.8
通讯作者：
Wang, Jeffrey C.
中科院分区：
文献类型：
--
作者：
Lao, Lifeng;Daubs, Michael D.;Wang, Jeffrey C.
目的探讨在传统中性位影像基础上增加颈椎屈伸位MRI检查是否有助于诊断颈椎间盘突出症。方法500例患者行中立位、屈伸位MRI检查。利用计算机软件对图像进行分析，客观量化椎间盘突出的程度。结果与中立位相比，伸展位椎间盘突出明显增加（P< 0.05），屈曲位椎间盘突出无显著差异（P< 0.05）。无椎间盘突出或中性椎间盘突出< 3mm的患者，2.97%的患者在屈曲时椎间盘突出增加至≥3mm， 16.41%的患者在伸展时椎间盘突出增加至≥3mm。对于基线椎间盘突出3 - 5 mm的中性视图患者，3.73%的患者在屈曲时突出增加到≥5 mm， 11.57%的患者在伸展时突出增加到≥5 mm。结论伸位片检查颈椎间盘突出程度明显高于单纯中立位片。运动MRI视图提供了有价值的附加信息，特别是在症状性神经根病存在而传统中性MRI未显示任何异常的情况下。
PurposeTo determine if adding flexion and extension MRI studies to the traditional neutral views would be beneficial in the diagnosis of cervical disc bulges.MethodsFive hundred patients underwent MRI in neutral, flexion and extension positions. The images were analyzed using computer software to objectively quantify the amount of disc bulge.ResultsCompared to the neutral position, cervical disc bulges were significantly increased in the extension position (P< 0.05), but on flexion position, there was no significant difference (P> 0.05). For patients without or <3 mm of disc bulge in neutral, 2.97 % demonstrated an increase in bulge to ≥3 mm bulge in flexion, and 16.41 % demonstrated an increase to ≥3 mm bulge in extension. For patients in the neutral view that had a baseline disc bulge of 3−5 mm, 3.73 % had increased bulges to ≥5 mm in flexion and 11.57 % had increased bulges to ≥5 mm in extension.ConclusionA significant increase in the degree of cervical disc bulge was found by examining extension views when compared with neutral views alone. Kinematic MRI views provide valuable added information, especially in situations where symptomatic radiculopathy is present without any abnormalities demonstrated on traditional neutral MRI.