多层螺旋CT增强扫描及三维后处理技术诊断椎动脉型颈椎病

目的探讨多层螺旋CT增强扫描及三维后处理技术在椎动脉型颈椎病诊断中的应用价值.方法收集经临床诊断为椎动脉型颈椎病并行MSCT增强检查的患者63例,设立无颈椎病症状者30例为对照组,利用三维后处理技术处理图像,观察椎动脉、横突孔及钩椎关节的形态学变化并进行对比分析.结果 63例中11例椎动脉表现正常,双侧椎动脉异常2例,单侧椎动脉变细38例,椎动脉局限性狭窄7例,椎动脉闭塞5例;30例对照组中椎动脉正常23例,单侧椎动脉变细7例.椎动脉正常和血管变细两种CTA表现出现比率分别经统计学处理均有显著差异(P<0.01).63例患者中横突孔两侧对称且大小正常者24例(38%),36例一侧横突孔变小(57%);对照组中22例两侧横突孔大小正常且两侧对称(73%),5例(17%)横突孔变小.两组间横突孔变小出现比率差异显著(P<0.01).结论多层螺旋CT增强扫描及三维后处理技术能够清晰显示椎动脉、横突孔及钩椎关节等结构的改变,在椎动脉型颈椎病诊断中具有很重要的应用价值.

Enhanced multi-slice CT and three-dimensional post processing techniques in vertebral arterial insufficiency caused by cervical spondylosis

Objective To explore the useful value of enhanced multi-slice CT (MSCT) and three-dimensional post processing technique in diagnosis of vertebral arterial insufficiency due to cervical spondylosis. Methods Sixty-three patients accepted contrast-enhanced MSCT examination. Thirty cases with no vertebral arterial insufficiency also performed the same scanning as a control group. The three-dimensional post processing images of two groups were analyzed and compared. Results Among 63 cases, vertebral artery showed normal in 11 cases, bilateral vertebral artery abnormal in 2 patients, unilateral vertebral artery thin in 38 cases, local stenosis of vertebral artery in 7 cases and obstruction in 5 cases. For control group of 30 cases, vertebral artery showed normal in 23 cases, unilateral vertebral artery thin in 7 cases. There was statistically significant difference between two groups in vertebral artery normal and thin, respectively ( P <0.05). Bilateral transverse foramen showed symmetrical and normal in size in 24 cases (38%), only unilateral transverse foramen smaller in 36 cases (57%). In control group, bilateral transverse foramen showed symmetrical and normal in size in 22 cases (73%), right transverse foramen smaller in 5 cases (17%). Significant difference existed between study group and control group in transverse foramen changes in size ( P <0.01). Conclusion Contrast-enhanced MSCT scanning and three-dimensional post processing images can show clearly changes of vertebral artery and bone structures. It possesses the important value in diagnosis of vertebral arterial insufficiency due to cervical spondylosis.