Citation: | TAO Yifan, LUO Fei. Predictive value of enhanced magnetic resonance imaging for pathological classification and prognosis of conservative treatment in patients with lumbar disc herniation[J]. Journal of Clinical Medicine in Practice, 2024, 28(24): 1-5. DOI: 10.7619/jcmp.20242121 |
To explore the predictive value of enhanced magnetic resonance imaging (MRI) for pathological classification and prognosis of conservative treatment in patients with lumbar disc herniation.
Clinical materials of 105 patients with conservative treatment for lumbar disc herniation in the hospital from September 2021 to September 2022 were retrospectively analyzed. All the patients underwent enhanced MRI at the time points of hospital admission and the final examination. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of enhanced MRI parameters [maximal rim thickness (Tr), rim enhancement range (Er), and herniated volume] in the pathological classification of lumbar disc herniation. Patients were followed up for 8 months and divided into recurrence and non-recurrence groups based on recurrence after conservative treatment. The Oswestry Disability Index (ODI) score, the Visual Analogue Scale (VAS) score for low back pain, and levels of enhanced MRI parameters were compared between the two groups. ROC curve analysis was conducted to assess the predictive value of Tr, Er and herniated volume for the prognosis.
The levels of Tr and Er in the extrusion patients were significantly higher than those in the sequestration patients (P < 0.05). The area under the curve (AUC) for the prediction of pathological classification of lumbar disc herniation by Tr combined with Er was 0.854, with a sensitivity of 84.21% and a specificity of 76.12%. After treatment, the ODI score and VAS score for low back pain in the non-recurrence group were significantly lower than those in the recurrence group, while Tr and Er were significantly higher in the non-recurrence group (P < 0.05).The AUC for the prediction of the prognosis of conservative treatment for lumbar disc herniation by Tr combined with Er was 0.802, with a sensitivity of 96.55% and a specificity of 53.95%.
Enhanced MRI has good value in assessing the pathological classification and prognosis of conservative treatment in patients with lumbar disc herniation.
[1] |
葛郁龙, 康银辉. 术前坐骨神经传导速度与腰椎间盘突出症经皮椎间孔镜下椎间盘切除治疗效果相关性研究[J]. 陕西医学杂志, 2022, 51(10): 1253-1255.
|
[2] |
邵海龙, 穆佐洲. 机体炎症水平和氧化应激水平与腰椎间盘突出症椎间孔镜术后残留疼痛相关性研究[J]. 陕西医学杂志, 2022, 51(10): 1274-1277, 1281.
|
[3] |
俞鹏飞, 姜宏, 马智佳, 等. 增强MRI对脱出和游离型腰椎间盘突出症转归的预测价值[J]. 中华骨科杂志, 2021, 41(18): 1350-1360.
|
[4] |
SHER I, DALY C, OEHME D, et al. Novel application of the pfirrmann disc degeneration grading system to 9. 4T MRI: higher reliability compared to 3T MRI[J]. Spine, 2019, 44(13): E766-E773. doi: 10.1097/BRS.0000000000002967
|
[5] |
OBMANN V C, MARX C, BERZIGOTTI A, et al. Liver MRI susceptibility-weighted imaging (SWI) compared to T2* mapping in the presence of steatosis and fibrosis[J]. Eur J Radiol, 2019, 118: 66-74. doi: 10.1016/j.ejrad.2019.07.001
|
[6] |
DIVI S N, GOYAL D K C, MAKANJI H S, et al. Can imaging characteristics on magnetic resonance imaging predict the acuity of a lumbar disc herniation[J]. Int J Spine Surg, 2021, 15(3): 458-465. doi: 10.14444/8032
|
[7] |
中华医学会骨科学分会脊柱外科学组, 中华医学会骨科学分会骨科康复学组. 腰椎间盘突出症诊疗指南[J]. 中华骨科杂志, 2020, 40(8): 477-487.
|
[8] |
WONG D A, TRANSFELDT E. MacNabs Backache[M]. 4th ed. Baltimore: Lippincott Williams & Wilkins, 2006: 198.
|
[9] |
郑光新, 赵晓鸥, 刘广林, 等. Oswestry功能障碍指数评定腰痛患者的可信性[J]. 中国脊柱脊髓杂志, 2002, 12(1): 13-15.
|
[10] |
SUNG Y T, WU J S. The Visual Analogue Scale for Rating, Ranking and Paired-Comparison (VAS-RRP): a new technique for psychological measurement[J]. Behav Res Methods, 2018, 50(4): 1694-1715. doi: 10.3758/s13428-018-1041-8
|
[11] |
MARCIA S, ZINI C, BELLINI M. Image-guided percutaneous treatment of lumbar stenosis and disc degeneration[J]. Neuroimaging Clin N Am, 2019, 29(4): 563-580. doi: 10.1016/j.nic.2019.07.010
|
[12] |
李新巧, 单前前, 徐元屿, 等. 神经根脉冲射频对腰椎间盘突出症术后残余神经痛的影响[J]. 实用临床医药杂志, 2023, 27(6): 91-95. doi: 10.7619/jcmp.20223147
|
[13] |
宋希元, 汪冬梅, 李彦明. 退变椎间盘组织学改变与MRI评估的相关性研究[J]. 中国医师杂志, 2019, 21(8): 1243-1246.
|
[14] |
KOSE G, TASTAN S, TEMIZ N C, et al. The effect of low back pain on daily activities and sleep quality in patients with lumbar disc herniation: a pilot study[J]. J Neurosci Nurs, 2019, 51(4): 184-189. doi: 10.1097/JNN.0000000000000446
|
[15] |
HARPER R, KLINEBERG E. The evidence-based approach for surgical complications in the treatment of lumbar disc herniation[J]. Int Orthop, 2019, 43(4): 975-980. doi: 10.1007/s00264-018-4255-6
|
[16] |
GRVNEBOOM A, KLING L, CHRISTIANSEN S, et al. Next-generation imaging of the skeletal system and its blood supply[J]. Nat Rev Rheumatol, 2019, 15(9): 533-549. doi: 10.1038/s41584-019-0274-y
|
[17] |
王旸, 邹丹丹, 耿海涛, 等. MRI腰部成像参数与腰椎间盘突出症患者椎间孔镜术后疗效的关系[J]. 山东医药, 2021, 61(17): 58-61.
|
[18] |
李丹, 王莉霞, 吴文骏, 等. MRI T1rho对下腰痛者腰椎间盘退变的定量评估[J]. 磁共振成像, 2019, 10(12): 904-907.
|
[19] |
MENACHO K, ABDEL-GADIR A, MOON J C, et al. T2* mapping techniques: iron overload assessment and other potential clinical applications[J]. Magn Reson Imaging Clin N Am, 2019, 27(3): 439-451. doi: 10.1016/j.mric.2019.04.008
|
[20] |
赵兰锋, 王正阁. 增强MRI肿瘤-皮下脂肪信号强度比值鉴别椎管内神经鞘瘤与脊膜瘤[J]. 中国医学影像技术, 2022, 38(1): 49-52.
|
[21] |
申成春, 张峰, 陈云琳, 等. 增强MRI对脱出和游离型腰椎间盘突出症转归的预测临床价值[J]. 医学影像学杂志, 2022, 32(4): 709-712.
|
[22] |
陈福宇, 颜程, 张小克, 等. MRI对腰椎间盘突出症术后复发的预测价值分析[J]. 医学影像学杂志, 2022, 32(10): 1839-1843.
|
[23] |
韩君婷, 王莉, 黄冬, 等. 腰椎间盘突出髓核重吸收机制的研究进展[J]. 中华物理医学与康复杂志, 2021, 43(9): 853-857.
|