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• Clinical Article •
The shortcomings of conventional MR images in the diagnosis of lumbar disc herniation: comparative study with the results of surgical operation
ZHANG Shu-jun  CHEN Hai-song  ZHOU Rui-zhi  XU Qi 

DOI:10.12015/issn.1674-8034.2018.02.008.


[Abstract] Objective: To find out the shortcomings of the MR axial and sagittal images in the diagnosis of lumbar disc herniation by comparing with results of surgical operation and MR sagittal image and find out solutions.Materials and Methods: The MR images of 100 cases with lumbar disc herniation confirmed by surgical operation were retrospectively analyzed. MR conventional sequences (sagittal T1WI, T2WI and fat-suppressing sequences, axial T2WI) were observed. Using the surgical results as the standard, the diagnostic accuracy of disc herniation and the detection rate of the special signs of the disease were calculated and compared on sagittal and axial images, and the causes of misdiagnosis on axial and sagittal images were analyzed.Results: The accuracy of the diagnosis of the lumbar disc herniation using MR sagittal, axial images was 84.8%, 93.6%, respectively. Between axial and sagittal images there were significant differences (χ2=5.02, P<0.05); The detection rates of the lumbar disc herniation or prolapse shifting upward or downward and dissociate nucleus on axial MR images were 36.00% and 45.45%, respectively, which were significantly lower than that on the sagittal images of 96.00% and 100.00% (χ2=20.05, 8.25, P<0.05). The detection rate of lumbar disc herniation of foraminal and intervertebral foramen lateral type on axial images were 96.30% and 88.89%, respectively, which is significantly higher than that on the sagittal images of 74.07% and 38.89% (χ2=5.28, 9.75, P<0.05). The main reasons of transverse axial image misdiagnosis of the herniated disk were the scanning range limited to the intervertebral space.Conclusions: MR axial and sagittal images have their own advantages in the diagnosis of the lumbar disc herniation. To pay more attention to MR sagittal images, to increase the range of axial scanning when necessary, to perform 3D CT can avoid the misdiagnosis of the special intervertebral disc protrusion on the MR images.
[Keywords] Magnetic resonance imaging；Lumbar disc herniation；Sagittal；Transverse axis

ZHANG Shu-jun Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China

CHEN Hai-song* Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China

ZHOU Rui-zhi Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China

XU Qi Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China

*Correspondence to: Chen HS, E-mail: chs368@sina.com

Conflicts of interest   None.

Received  2017-07-24
Accepted  2017-09-06
DOI: 10.12015/issn.1674-8034.2018.02.008
DOI:10.12015/issn.1674-8034.2018.02.008.

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