Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Follow-Up MR Imaging Assessment of Natural History of Lumbar Disc Herniation in Patients with Recurred Low Back Pain

재발성 요통을 호소하는 환자들의 추적 요추부 자기공명영상에서 보이는 요추간판 병변의 변화

  • Lee, Kyung-Mi (Department of Radiology, Kyung Hee University Hospital, Kyung Hee University) ;
  • Park, Ji-Seon (Department of Radiology, Kyung Hee University Hospital, Kyung Hee University) ;
  • Ryu, Kyung-Nam (Department of Radiology, Kyung Hee University Hospital, Kyung Hee University) ;
  • Park, So-Young (Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University) ;
  • Jin, Wook (Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University)
  • 이경미 (경희대학교 경희의료원 영상의학과) ;
  • 박지선 (경희대학교 경희의료원 영상의학과) ;
  • 류경남 (경희대학교 경희의료원 영상의학과) ;
  • 박소영 (경희대학교 강동경희대병원 영상의학과) ;
  • 진욱 (경희대학교 강동경희대병원 영상의학과)
  • Received : 2011.05.12
  • Accepted : 2011.06.30
  • Published : 2011.08.31
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Abstract

Purpose : To compare lumbar disc changes between initial lumbar spine (L-spine) MRI and follow-up (f/u) MRI that were performed due to recurred backaches. Materials and Methods : A total 50 patients who had undergone f/u L-spine MRI were retrospectively reviewed. Five discs (L1-S1) were surveyed in each f/u MRI. Lumbar disc changes were defined as no change, aggravations, or improvements compared to initial disc states. These states were defined on the basis of morphologic status and disc levels. Results : In a total of 250 discs in 50 patients, 31 discs (12.4%) showed morphologic changes of disc lesions, whereas 219 discs (87.6 %) showed no changes. Among the 31 disc lesions, 24 were aggravated and 7 were partially improved. And on the basis of disc status, initially abnormal discs revealed any morphologic changes of the degree of disc herniation. A total of 33.3% of the morphologic changes are noted in initially extruded discs. Fifteen morphologic changes of disc lesions were located at the L4-5 level. Conclusion : Our results suggest that correlations between lumbar disc herniations and back pain symptoms are limited, and that evaluations of extra disc lesions are required.

목적 : 재발성 요통을 호소하는 환자들에서 최초 증상 발생시 촬영한 요추부 자기공명영상과 증상 재발시 촬영한 추적 요추부 자기공명영상을 비교하여 요추간판 병변의 변화 양상을 알아보고자 한다. 대상 및 방법 : 요통이 재발하여 추적 요추부 자기공명영상을 촬영한 50명의 환자 (연령범위 15~79세, 평균나이 49.8세)의 추간판 소견을 후향적으로 분석하였다. 최초 증상 발생시 촬영한 요추부 자기공명영상과 비교하여, 추적 자기공명영상에서 제 1-2 요추간판부터 제 5 요추-1천골 추간판 각각에 대한 형태학적 변화 유무와 변화가 있을 경우 호전 또는 악화를 평가하였다. 결과 : 50명의 환자, 250개의 추간판에서 219개 (87.6%)의 추간판은 변화를 보이지 않았다. 반면에 변화를 보인 31개 (12.4%)의 추간판에서 24개는 악화되었고, 7개는 완화되었다. 최초 추간판의 형태학적 상태를 기준으로 추적 관찰시, 형태학적 변화를 보인 경우는 모두 최초 자기 공명영상에서 추간판의 팽대, 돌출 혹은 탈출을 보였는데, 그 중 탈출되었던 추간판이 33.3%로 가장 많은 변화를 보였다. 요추간판 level을 기준으로 추적 관찰시, 제 4-5 요추간판이 15개로 가장 많은 변화를 보였다. 결론 : 재발성 요통은 추적 자기공명영상에서 추간판 탈출의 악화와 연관성이 낮은 것으로 판단되며, 요통을 유발할 수 있는 다른 원인에 대한 종합적인 평가가 필요하다고 본다.

Keywords

References

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