Summary
Two hundred and eleven patients with lumbar disc herniation at 242 levels were divided into 5 groups by their appearances on magnetic resonance imaging (MRI), and the findings at operation were compared to assess the accuracy of the MRI classification. There were no negative explorations. There was 92% sensitivity, 91% specificity and 92% accuracy for MRI in distinguishing protruded discs from other forms of lumbar disc herniation. For sequestrated discs there was 92% sensitivity, 99% specificity and 97% accuracy. In the extruded subligamentous type there was 71% sensitivity, 82% specificity and 79% accuracy, and 52% sensitivity, 92% specificity and 81% accuracy in the extruded transligamentous type. The overall accuracy of MRI predicting the types of herniated lumbar intervertebral disc was 85%. High resolution MRI is sensitive in detecting disc disease and specific in characterizing various subgroups of disc herniation, especially those which are sequestrated.
Résumé
Deux cent onze patients atteints de hernie discale lombaire, confirmée par imagerie par résonance magnétique (IRM) et représentant 242 niveaux, ont été répartis en cinq groupes. Le diagnostic IRM a été comparé aux constatations opératoires afin d'évaluer de façon prospective la précision diagnostique de la classification IRM. Il n'y a pas eu d'exploration discale négative. Pour la distinction entre protrusion et autres types de hernie discale, la sensibilité, la spécificité et l'exactitude de l'IRM ont été respectivement de 92%, 91% et 92%. Pour la séquestration discale, la sensibilité a été de 92%, la spécificité de 99% et l'exactitude de 97%. En ce qui concerne l'extrusion sous-ligamentaire, on a noté une sensibilité de 71%, une spécifité de 82% et une exactitude de 79%, tandis que pour les extrusions trans-ligamentaires la sensibilité a été de 52%, la spécifité de 92% et l'exactitude de 79%. L'exactitude moyenne pour la prévision du type de hernie discale a donc été de 85%. L'IRM de haute résolution est donc très efficace pour la détection des lésions discales et leur classification.
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Kim, K.Y., Kim, Y.T., Lee, C.S. et al. Magnetic resonance imaging in the evaluation of the lumbar herniated intervertebral disc. International Orthopaedics 17, 241–244 (1993). https://doi.org/10.1007/BF00194188
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DOI: https://doi.org/10.1007/BF00194188