摘要
背景:诱发性椎间盘造影测试适用于椎间盘源性腰痛,是确诊椎间盘源性腰痛的惟一方法,但患者术中对压力变化下的主观感受的把握不是很确定,无法量化和标准化,以至于不能正确判断,导致间盘造影结果存在一定的假阳性率。目的:探索在椎间盘造影术中可以调控的注射压力在提高诊断椎间盘造影阳性准确率,降低假阳性率中的作用。方法:随机选择33例患者共71个椎间盘行可控压力式椎间盘造影,根据间盘造影阳性的标准,共计间盘造影阳性患者共18例,包括阳性间盘23个,退变间盘15个,正常间盘3个;造影阴性患者15例,包括退变间盘23个,正常间盘7个。分别记录每个造影间盘的压力值和相应间盘注射对比剂量值。结果与结论:间盘造影阳性的阳性间盘中低压力(≤299.93kPa)与其他两组退变间盘差异有显著性意义(P<0.05)。阳性间盘的平均压力低于正常间盘内的压力,低于299.93kPa,当299.93kPa<压力≤499.89kPa时,间盘造影阳性组阳性间盘数明显少于其他两个退变组。3组间平均剂量差异无显著性意义(P>0.05)。提示小压力下(≤299.93kPa)椎间盘造影阳性的患者其确定为椎间盘源性腰痛的准确率更高;当299.93kPa<压力≤499.89kPa时,行椎间盘造影假阳性率较高;注射剂量对于间盘造影阳性无鉴别意义。
BACKGROUND：Induced discography can be used in discogenic pain and has been used as the only method for confirming discogenic pain. However,the subjective feeling during pressure changing is not accurate,quantitative or standardized,leading to false positive rate. OBJECTIVE：To explore the role of the control-pressure discography in improving the accuracy rate of discogenic pain and decreasing the false positive in the discography. METHODS：A total of randomly selected 71 discs of 33 patients underwent the control-pressure discography. According to the standard of positive discography,there were 18 positive patients,including 23 positive discs and 15 degenerated discs and 3 normal discs; 15 negative patients,including 23 degenerated discs and 7 normal discs. The control-pressure value and the dose value of each disc were recorded. RESULTS AND CONCLUSION：The low pressure in positive discs （≤ 299.93kPa） was significantly different from other degenerated discs （P 0.05）. The mean pressure of positive discs was lower than normal disc （ 299.93kPa）. When the pressure was 299.93 kPa but ≤499.89 kPa,the number of positive discs was significantly less than other two degenerated groups. No difference was detected in mean dose among three groups （P 0.05）. Results showed that the accurate rate of the positive patients definite to be discogenic pain was higher by low pressure （≤ 299.93 kPa）. The false positive rate was higher by pressure 299.93 kPa but ≤499.89 kPa. It is no value of injected dose to distinguish the positive discography.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第39期7358-7361,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
