CAJ | 학술논문

目的：探讨磁共振椎间盘造影（MRD）与 CT 椎间盘造影（CTD）诊断结果的一致性和相关性。方法36例96节腰椎间盘在 C 形臂导引下注入钆特酸葡胺（gadoterate meglumine，GD-DOTA）与碘海醇混合对比剂，于术后15 min、1 h 分别进行 CT 和 MR 检查，按照 Dallas 分级盲法评估 CTD 和 MRD结果，分析 MRD 与 CTD 的一致性、相关性及 MRD 的诊断价值。结果 MRD 与 CTD 椎间盘退行性变程度分级具有高度一致性（Kappa =0．985，P =0．000）和相关性（ICC =1．00，P =0．000；r =0．997，P =0．000），对纤维环破裂程度分级也具有较高一致性（Kappa =0．836，P =0．000）和相关性（ICC =0．90，P =0．000；r =0．869，P =0．000）。结论 MRD 是诊断椎间盘退变程度和纤维环破裂程度的准确方法，与 CTD有高度的相关性和一致性。
목적：탐토자공진추간반조영（MRD）여 CT 추간반조영（CTD）진단결과적일치성화상관성。방법36례96절요추간반재 C 형비도인하주입구특산포알（gadoterate meglumine，GD-DOTA）여전해순혼합대비제，우술후15 min、1 h 분별진행 CT 화 MR 검사，안조 Dallas 분급맹법평고 CTD 화 MRD결과，분석 MRD 여 CTD 적일치성、상관성급 MRD 적진단개치。결과 MRD 여 CTD 추간반퇴행성변정도분급구유고도일치성（Kappa =0．985，P =0．000）화상관성（ICC =1．00，P =0．000；r =0．997，P =0．000），대섬유배파렬정도분급야구유교고일치성（Kappa =0．836，P =0．000）화상관성（ICC =0．90，P =0．000；r =0．869，P =0．000）。결론 MRD 시진단추간반퇴변정도화섬유배파렬정도적준학방법，여 CTD유고도적상관성화일치성。
Objective To explore the diagnostic consistency and correlation between MR discography (MRD) and CT discography (CTD) in diagnosing chronic low back pain. Methods Guided by C - arm fluoroscopy the mixed solution of gadoterate meglumine (GD-DOTA) and Iohexol (GD-DOTA at a dilution of 1 ∶ 400 with Iohexol) was injected into 96 lumbar intervertebral discs of the 36 patients. CT scanning was performed at 15 minutes after the injection of contrast, and axial together with sagittal SE T1WI MR scanning was carried out one hour after the injection. CTD and MRD images were randomly numbered and were independently evaluated by two experienced radiologists according to Dallas discogram scale in order to assess the diagnostic consistency and correlation between (MRD) and (CTD). In addition the diagnostic value of MRD was evaluated. Results The results revealed that in determining disc degeneration grade CTD and MRD were highly consistent with each other(Kappa = 0.836, P < 0.01), and the diagnostic results judged by the two reviewers were essentially in agreement (ICC = 1.00, P < 0.01; r = 0.997, P < 0.01). Higher consistency (Kappa = 0.836, P < 0.01) and correlation(ICC = 0.90, P < 0.01; r = 0.869, P < 0.01; Kappa =0.836, P < 0.01) in determining annulus rupture extent were also obtained. Conclusion MRD is an accurate diagnostic method for the determination of disc degeneration and the severity of annulus rupture, and this technique has greater consistency and correlation with CTD in diagnosing chronic low back pain.