Diagnostic Value of Coronal Magnetic Resonance Imaging and PROSET Water Excitation Sequence in the Pathogenic Segments of Multilevel Lumbar Disc Herniation
Objective To evaluate the accuracy and practicability of coronal magnetic resonance imaging and PROSET water excitation sequence in the diagnosis of multiple levels of lumbar disc herniation.Methods The clinical data of 66 patients with multilevel lumbar disc herniation who received surgical treatment in our hospital from January 2019 to December 2022 were retrospectively analyzed.The MRI scanning sequence was performed using a 3.0TMR scanner(Philips Ingenia,Netherlands,3.0T),followed by a coronal PROSET water challenge sequence.To collect the manifestations of multilevel lumbar disc herniation on MRI images and its relationship with compressed nerve roots.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of coronal MRI diagnosis of compressed nerve roots were calculated based on the intraoperative and postoperative patient efficacy as the judgment criteria.Kappa consistency analysis was used to analyze the diagnostic consistency between the two.Results In 66 patients with multilevel lumbar disc herniation,MRI images identified a total of 31 patients with 2-level lumbar disc involvement,25 patients with 3-level lumbar disc involvement,and 10 patients with 4-level lumbar disc involvement,involving 177 intervertebral discs.On coronal lumbar MRI,there are a series of morphological changes in nerve root compression caused by spinal disc herniation,including nerve root depression,ganglion signal enhancement,nerve root swelling or nerve root fracture.The L4/L5 nerve root origins are mostly located at 69.81％of the intervertebral disc plane,while the L5/S1 nerve root origins are mostly located at 72.58％above the intervertebral disc.A total of 79 nerve roots were compressed,with L5 having the highest compression rate of 82.28％(65/79).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of coronal MRI in locating the diseased segment in patients with multi-level Spinal disc herniation were 97.4％,99.3％,93.7％,98.6％,and 98.6％respectively.High consistency with intraoperative and postoperative diagnosis of Kappa(k=0.926)were fund.Conclusion Coronal MRI has a high accuracy in locating the diseased segments and compressed nerve roots of patients with multilevel Spinal disc herniation,which is worthy of further study in the future.
Multiparameter Magnetic Resonance ImagingSpinal Disc HerniationNerve Root
NETL
NSTL
万方数据
维普
