多排螺旋CT对成人腰椎小关节病的诊断价值

目的:探讨多排螺旋CT对成人腰椎小关节病的诊断价值及临床意义.方法:回顾性分析临床及影像资料齐全的71例腰椎小关节病,对发病的腰椎小关节形态、病变数目、椎间盘形态及密度等指标进行了观察.结果:所有病例均有多排螺旋CT检查,其中52例同时有X线检查.腰椎小关节病的多排螺旋CT表现关节突增生肥大56例,小关节间隙变窄49例,32例关节面凹凸不平并伴有骨性关节面下小的囊性变.18例腰椎小关节内出现真空征象,12例关节脱位或半脱位,7例椎小关节囊钙化,表现为小关节间隙内或外侧缘出现新月形钙化.同时合并椎问盘膨出25例,椎间盘突出37例.在52例X线片中,23例椎小关节模糊,间隙狭窄,同时伴有骨质增生硬化,29例未发现确切的异常征象.结论:X线对腰椎小关节病的诊断仅限于对关节面骨质及关节间隙宽窄度的评价,而多排螺旋CT是诊断成人腰椎小关节病的首选方法,它能清楚地鉴别椎小关节病和椎间盘病变.

THE DIAGNOSTIC VALUE OF MULTI-SLICE SPIRAL CT FOR ADULT LUMBAR FACET JOINT DISEASE

Objective:To explore the diagnostic value and clinical significance of the Multi-slice spiral CT for adult lumbar facet joint disease.Methods;71 cases of lumbar facet joint disease with sufficient clinical and imaging information were analysized retrospectively.The observed features include the lesion shape and number of vertebral facet joint,intervertebral disc shape and density.Results:All patients had multi-slice spiral CT examination,of whom 52 cases had the examination of X-ray at the same time.The Multi-slice spiral CT features of vertebral facet joint disease showed facet hypertrophy in 56 cases,small joint space narrowing in 49 cases,and rugosity in articular surface in 32 cases,accompanied by bone cystis degeneration under the articular surface.18 cases showed vacuum phenomenon sign of joint space,and 12 cases dislocation or subluxation,7 cases showed calcification around the joint capsule.At the same time,25 cases were accompanied with intervertebral disc bulging,37 cases with intervertebral disc herniation.Of 52 cases with X-ray examination,23 cases showed a small joint fuzzy,narrow gap,accompanied by hyperosteogeny sclerosis,while 29 cases found no abnormal signs.Conclusion:X-ray examination value of the lumbar facet joint disease is limited to display the articular surface of bone and joint space width degree,MSCT is the first choice examination method for the diagnosis of adult lumbar facet joint disease,CT examination can show the difference between the small vertebrae joint disease and intervretebral disc disease.