中老年腰椎间盘突出症的CT诊断(附56例报告)

目的：分析中老年腰椎间盘突出症的CT表现，评价CT对腰椎间盘突出症的诊断价值及限度。材料与方法：收集经手术证实的中老年腰椎间盘突出症56例，对它们的CT征象进行回顾性分析。结果：CT诊断中老年腰椎间盘突出症的符合率为85．7％；CT分型：中心后型，后外侧型，椎间孔内或外型；主要CT表现有：(1)腰椎间盘后缘局限性后突软组织密度块影，边缘光滑，硬膜囊受压、变形；(2)游离碎块形成；(3)神经根受压、水肿或湮没；(4)突出髓核部分钙化或骨化；此外，CT还能清楚显示椎管及侧隐窝狭窄、黄韧带肥厚、小关节病变以及椎间盘真空征等合并征象。结论：CT是诊断中老年腰椎间盘突出症的首选检查方法，大部分病例经CT检查可作出正确诊断。

CT Diagnosis of Middle and Old-aged with Lumbar Disc Herniation (A Report of 56 Cases)

Purpose: To analyse the CT features of the middle and old - aged lumbar disc herniation, and to evaluate the value and limitations of CT diagnosis of lumbar disc herniation. Materials and Methods: CT findings of 56 cases of middle and old - aged herniated lumbar disc verified by surgery were retrospectively analysed. Results: The accuracy of CT diagnosis was 85.7% . The types of CT diagnosis of the herniation were divided into posterior and central - type, posterolateral - type, intra or extraforaminal - type. The CT features included: (1) Profusion of soft tissue density mass with edge smooth into the canal from posterior annulus, Compression and indentation of dural sac; (2) Free fragments formation; (3) Compression nad swelling or entrapping of the nerve root; (4) Partial calcification of ossification of the herniated disc ; in addition, accompanying abnormalities such as stenosis of the spinal canal or lateral recess, thickening of ligament flavum, degenerative facet osbeoarthritis and vacuum phenomenon could be seen. Conclusion: CT is the first imaging method for detecting lumbar disc herniation, the majority of cases can be correctly diagnosed by CT.