目的 探讨MRI影像学表现对椎间盘源性腰痛的诊断价值.方法 对我院2002年5月-2007年5月诊断椎间盘源性腰痛207例(393个椎间盘)的MRI影像学资料进行汇总,观察椎间盘异常信号改变并进行综合分析.结果 本组393个椎间盘行椎间盘造影,诊断为椎间盘源性疼痛221个,其中120个椎间盘显示椎间盘后纤维环存在高信号区(high intensity zone,HIZ)改变,出现一致性疼痛114个(95％),非一致性疼痛6个(5％)；116个椎间盘出现椎间盘退变改变,出现一致性疼痛26个(22％),非一致性疼痛90个(78％)；53个椎间盘出现Modic征改变,出现一致性疼痛36个(68％),非一致性疼痛17例(32％).上述三种情况组内一致性疼痛发生率与非一致性疼痛的发生率比较差异均有统计学意义(P＜0.05).结论 MRI表现为椎间盘HIZ高信号区改变与腰椎间盘源性疼痛密切相关.%Objective To explore diagnostic value of MRI eikonic expression in diagnosis of dysgenic low back pain. Methods MRI data of 207 patients (393 discs) with discogenic low back pain during May 2002 and May 2005 in our hospital were collected and comprehensively analyzed according to abnormal signal changes of intervertebral disc. Results In 339 discographies, there were 221 discs of dysgenic pain, in which 120 discs had a high signal area (high intensity zone, HIZ) changes in the intervertebral disc annul us fibrosus, 114 discs (95% ) with consistency of pain, 4 discs (5% ) with non-conformance pain; 116 discs had intervertebral disc degeneration, 26 discs (22% ) with consistency of pain, 90 (78% ) with non-conformance pain; 53 discs had Modic sign change, 36 discs (68% ) with consistency pain and 17 discs (32% ) with non-conformance pain. The differences were statistically significant between incidence rates of consistency pain and non-conformance pain in the three conditions (P <0.05). Conclusion MRI eikonic expression has a close relationship with HIZ high signal area changes and dysgenic low back pain.
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