到底是报椎间盘突出还是椎间盘膨出?

2022-02-19 普罗旺斯 华夏影像诊断中心

一文读懂~

椎间盘突出还是椎间盘膨出?几乎每个CT或者MR的影像医生在工作中都会碰到这样一个问题。一般我们在报告中有一句大概这样描述:

椎间盘软组织密度(信号)局限性向后(左后、右后)突出,硬脊膜囊受压——椎间盘突出;

椎间盘软组织密度(信号)均匀向周围突出,硬脊膜囊受压,——椎间盘膨出。

我们来看看椎间盘的正常解剖:

图片

图片
               (正常椎间盘)

如果椎间盘这样:

 

图片

图片

 

那就很简单——椎间盘突出

 

图片

图片

这个也好说——椎间盘膨出

但是工作中不是都是这样典型的,或者n处在二者之间的,怎么报?刚开始工作的时候,一直有个误区:矢状位看着严重的就报突出,较轻的就报膨出,不知道各位老师是怎么判断的?

后来,在华中科技大学同济医院进修学习时,有位知识渊博的教授(是我发自内心的)告诉我一个好办法,在此特意分享一下:

图片
(我自己用钢笔画的,有点丑,见笑了)

就是看椎间盘突出的边缘占整个边缘的比率,或者看我画的那个角度,以180°为界限,小于报突出,大于报膨出。

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    2022-04-27 ms6000001090533026

    在另一篇文章看到的角度和楼主不一样哎https://www.medsci.cn/article/show_article.do?id=ae133006e797

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1215084, encodeId=10ef121508412, content=在另一篇文章看到的角度和楼主不一样哎https://www.medsci.cn/article/show_article.do?id=ae133006e797, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42c76539859, createdName=ms6000001090533026, createdTime=Wed Apr 27 18:38:59 CST 2022, time=2022-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683793, encodeId=c1f61683e935c, content=<a href='/topic/show?id=599862899ba' target=_blank style='color:#2F92EE;'>#椎间盘突出#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62899, encryptionId=599862899ba, topicName=椎间盘突出)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=104527995107, createdName=lfyang, createdTime=Fri Apr 01 13:53:33 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197314, encodeId=8975119e3149b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96086523945, createdName=ms6000001154688722, createdTime=Fri Feb 25 21:12:06 CST 2022, time=2022-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195417, encodeId=98e9119541e66, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e1466167480, createdName=ms3000000089219083, createdTime=Sun Feb 20 19:25:41 CST 2022, time=2022-02-20, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1215084, encodeId=10ef121508412, content=在另一篇文章看到的角度和楼主不一样哎https://www.medsci.cn/article/show_article.do?id=ae133006e797, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42c76539859, createdName=ms6000001090533026, createdTime=Wed Apr 27 18:38:59 CST 2022, time=2022-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683793, encodeId=c1f61683e935c, content=<a href='/topic/show?id=599862899ba' target=_blank style='color:#2F92EE;'>#椎间盘突出#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62899, encryptionId=599862899ba, topicName=椎间盘突出)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=104527995107, createdName=lfyang, createdTime=Fri Apr 01 13:53:33 CST 2022, time=2022-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197314, encodeId=8975119e3149b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96086523945, createdName=ms6000001154688722, createdTime=Fri Feb 25 21:12:06 CST 2022, time=2022-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195417, encodeId=98e9119541e66, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e1466167480, createdName=ms3000000089219083, createdTime=Sun Feb 20 19:25:41 CST 2022, time=2022-02-20, status=1, ipAttribution=)]
    2022-02-25 ms6000001154688722

    学习了

    0

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    2022-02-20 ms3000000089219083

    学习

    0

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