Pfirrmann 椎间盘退变的MRI(T2WI)分级标准.doc

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1、Pfirrmann椎间盘退变的MRI(T2WI)分级标准分级结构髓核与纤维环边界信号椎间盘高度Ⅰ质均，色亮白清高或等于脑脊液正常Ⅱ非均质，有或无水平带清高或等于脑脊液正常Ⅲ非均质，灰不清中等正常或轻度降低Ⅳ非均质，灰或黑消失中等或低信号正常或中度降低Ⅴ非均质，黑消失低信号椎间盘间隙塌陷Figure1.A-E,腰椎间盘退变的分级系统，逐渐退变严重:GradeI:thestructureofthediscishomogeneous,withbrighthyperintensewhitesignalintensityanynormaldisc

2、height.GradeII:thestructureofthediscisinhomogeneous,withthehyperintensewhitesignal.Thedistinctionbetweennucleusandannulusisclear,andthedischeightisnormal,withorwithoutahorizontalgraybands.GradeIII:thestructureofthediscisinhomogeneous,withanintermittentgraysignalintensity

3、.Thedistinctionbetweennucleusandannulusisunclear,andthedischeightisnormalorslightlydecreased.GradeIV:thestructureofthediscisinhomogeneous,withahypointensedarkgraysignalintensity.Thedistinctionbetweenthenucleusandannulusislost,thedischeightisnormalormoderatelydecreased.Gr

4、adeV:thestructureofthediscisinhomogeneous,withahypointenseblacksignalintensity.Thedistinctionbetweennucleusandannulusislost,andthediscspaceiscollapsed.GradingisperformedonT2-weightedMid-sagittalfastspin-echoimages.Pfirrmann腰椎间盘突出MRI分级是一种很直观的分级，是MRI横断面上突出间盘和神经跟的关系确定的一种分级（

5、如下图所示）。PfirrmannI级突出间盘与神经跟无接触PfirrmannII级突出间盘与神经根接触，神经根无移位PfirrmannIII级突出间盘与神经根接触，神经根向后移位PfirrmannIV级突出间盘与神经根接触，神经根压至椎管后壁有些学者将Pfirrmann分级作为衡量间盘突出严重程度的标准，并以此作为选择不同手术的适应症。如棘突间固定系统Wallis系统的适应症包括PfirrmannII级、III级、IV级的间盘突出。