CT对腰椎附件发育异常的诊断价值

目的探讨CT对腰椎附件发育异常的诊断价值。方法回顾分析本院16例经X线平片和CT检查确诊的腰椎发育异常的病例。结果全部病例经1～2次X线平片检查均无阳性发现或仅见骨质增生改变;CT均可发现附件发育异常．如：椎板裂6例,横突不对称1例,关节突异常肥大2例,关节突呈“双突”畸形2例,双侧小关节不对称5例。结论CT是诊断腰椎附件发育异常的较好影像学方法。     

腰椎小关节退行性变的CT诊断

目的：探讨CT对腰椎小关节退变的诊断价值。方法：采用SOMTOMNOVA型CT机进行腰3-骶1椎间盘扫描。结果：CT扫查腰椎间盘病变，同时显示腰椎小关节退变，其表现有：椎小关节增生肥大、硬化；椎小关节变窄；椎小关节面下方囊性变；关节囊钙化、真空；关节退变性滑脱。结论：CT扫描是检查和诊断腰椎小关节退行性改变的有效方法。     

腰椎小关节退变的CT诊断

目的确定cT扫描对诊断腰椎小关节退变的可行性。方法208例临床疑诊腰椎小关节退变患者于临床症状出现后1个月～1a内均接受了螺旋cT扫描。结果cT扫描证实，208例中有313个腰椎小关节发生改变。腰椎小关节退变的cT表现主要是关节突增生肥大合并骨赘形成，椎小关节间隙变窄或消失，关节腔内“真空征”，关节面毛糙硬化，小关节半脱位，以及伴发椎间盘突出、膨出，黄韧带肥厚和钙化等。结论螺旋cT扫描可准确显示腰椎小关节的形态、结构及其异常改变，能为腰椎小关节退变的早期诊断提供可靠依据。     

退行性腰椎滑脱的CT表现

退行性腰椎滑脱是腰椎管狭窄的重要类型之一[1]。笔者对ＣＴ扫描中发现的60例退行性腰椎滑脱患者的ＣＴ表现进行了回顾性分析,旨在探讨其病因和ＣＴ的诊断价值。1　材料与方法本组60例,男24例,女36例,年龄41～80岁,平均51.2岁。60例均有腰痛症状。42例有坐骨神经痛,26例为单侧,16例为双侧。使用日立Ｗ950ＳＲＣＴ机,平行于椎间隙扫描3层,层厚5ｍｍ,层距5ｍｍ。据Ｅｄｎｏｎｓｏｎ法将滑脱分4度:Ⅰ度:上位椎体前移下位椎体前后径的25%以内;Ⅱ度:前移25%～50%;Ⅲ度:前移50%～75%;Ⅳ度:前移75%以上。2　结果2.1　病变分布本组60例中,单发病变56…     

腰椎滑脱的CT诊断

X线平片易明确诊断腰椎滑脱,而CT能准确观察椎间盘和椎小关节等结构的改变及其对硬膜囊和神经根的影响。故腰椎滑脱的CT检查使诊断更加精确且具有非常重要的临床价值。现报告28例,并对其CT表现进行分析。1资料与方法28例中男20例,女8例;年龄42~76岁,平均55·2岁。按椎体移位的方向分为前滑脱和后滑脱两型。其中前滑脱22例,后滑脱6例。主要临床表现:腰痛28例,单侧或双侧下肢痛16例,麻木5例。直腿抬高试验阳性17例,髌/跟腱反射减弱或消失12例。所有病例均使用Toshiba TCT-300/EZ型CT机。患者仰卧位,在腰椎侧位定位像上确定扫描线,扫描线…     

CT与MRI检查在腰椎退行性变诊断中的应用价值

目的对CT与MRI检查在腰椎退行性变诊断中的应用价值进行探讨。方法选取2018年1月-2019年1月收治的150例腰椎间盘退行性病变患者,均行CT与MRI检查,并对两种检查方法的诊断结果进行观察。结果相对于CT而言,在椎间盘突出时硬膜囊分界清晰率、椎间盘狭窄以及椎间盘突出方面MRI具有明显的优势,且在统计学上两者的比较差异有意义(P<0.05),但是相对于MRI而言,在纤维环与髓核钙化率以及椎间盘积气率方面CT具有明显的优势,且在统计学上两者的比较差异有意义(P<0.05)。结论在腰椎间盘退行性病变临床诊断中CT与MRI都有着较好的应用价值,只是这两种诊断方法都有着各自的优势,为了提高临床诊断的正确率,可以将两者进行联合应用。     

腰椎小关节退变的CT诊断及临床意义

目的探讨CT的诊断价值及其临床意义。方法回顾153例腰椎小关节退变的临床症状与诊断,分析椎小关节退变的CT影像改变,进行重新认识、领会与提高。结果椎小关节退变CT影像表现为:小关节突的骨质增生、硬化、骨赘形成,关节软骨侵蚀,关节间隙狭窄、积气,关节面下小囊变及周围筋膜、韧带的钙化等。结论 CT扫描可准确显示腰椎小关节形态、结构等退行性改变,在目前临床医师未足够重视的情况下,运用CT的高分辨特性,对椎小关节退变的早期诊断提供可靠依据,充分提高他们对椎小关节退变的认识,为临床医师正确治疗反复腰腿痛的患者提供很好的帮助。     

腰椎退变的CT表现（附300例分析）

笔者对３００例腰椎退变病人作了ＣＴ检查，就其ＣＴ表现进行分析，探讨退变的病理变化，引起临床症状的原因，为腰椎退变提供可靠的影像学根据。     

MRI of degenerative lumbar spine disease: comparison of non-accelerated and parallel imaging

Introduction Parallel imaging techniques such as GRAPPA have been introduced to optimize image quality and acquisition time. For spinal imaging in a clinical setting no data exist on the equivalency of conventional and parallel imaging techniques. The purpose of this study was to determine whether T1- and T2-weighted GRAPPA sequences are equivalent to conventional sequences for the evaluation of degenerative lumbar spine disease in terms of image quality and artefacts. Methods In patients with clinically suspected degenerative lumbar spine disease two neuroradiologists independently compared sagittal GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (25 patients) and transverse GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (23 lumbar segments in six patients). Comparative analyses included the minimal diameter of the spinal canal, disc abnormalities, foraminal stenosis, facet joint degeneration, lateral recess, nerve root compression and osteochondrotic vertebral and endplate changes. Image inhomogeneity was evaluated by comparing the nonuniformity in the two techniques. Image quality was assessed by grading the delineation of pathoanatomical structures. Motion and aliasing artefacts were classified from grade 1 (severe) to grade 5 (absent). Results There was no significant difference between GRAPPA and non-accelerated MRI in the evaluation of degenerative lumbar spine disease (P > 0.05), and there was no difference in the delineation of pathoanatomical structures. For inhomogeneity there was a trend in favour of the conventional sequences. No significant artefacts were observed with either technique. Conclusion The GRAPPA technique can be used effectively to reduce scanning time in patients with degenerative lumbar spine disease while preserving image quality.     

Percutaneous needle evaluation of intradural extramedullary lesions of the lumbar spine

Summary A total of eight patients in whom five intradural extramedullary lesions and three epidural lesions were present were evaluated by percutaneous needle biopsy. In four patients the level of aspiration biopsy was determined using the initial myelogram and in those patients fluoroscopic guided percutaneous needle biopsies were performed. Three of these patients had large intradural extramedullary masses (above 1 cm); one patient had an epidural lesion. Diagnostic material was obtained in all cases (medulloblastoma, astrocytoma, small cell carcinoma, adenocarcinoma). Immediate post procedure CT and clinical followup showed no complications. In three patients with small lesions (below 1 cm), post myelographic CT was used to determine the level of aspiration. Post myelographic CT showed an intradural extramedullary mass in one patient and epidural lesions in two cases. Plain CT showed a high attenuation lesion in one patient. CT guided percutaneous needle biopsies in these four patients yielded diagnostic specimens (neurofibroma, uroepithelial carcinoma, hematoma, Thorotrast deposit). Clinical follow up showed no complications. Our experience indicates that percutaneous needle biopsy of intradural extramedullary and epidural lesions of the lumbar spine is safe and efficacious. Depending upon the size of the lesions, myelography or CT can be utilized to determine the level of aspiration.     

Late contrast enhancement in the CT diagnosis of herniated lumbar disk

Summary Twenty-five patients clinically suspected of herniated lumbar disk have undergone a CT examination before and 40 min after contrast enhancement. In every case, 13 of which were surgically verified, significant contrast enhancement of herniated disks was seen; there was only one false positive case. The authors conclude that late contrast enhancement really improves the CT diagnosis of herniated lumbar disk, particularly in cases with a doubtful or negative precontrast scan. The mechanism of the late contrast enhancement is discussed.     

腰椎峡部裂CT征象的临床诊断价值

目的 :分析腰椎椎弓峡部裂的CT表现 ,探讨各个征象的诊断价值和意义。材料和方法 :自可疑椎弓峡部裂脊椎的椎弓根的上缘至下一个脊椎椎弓根的上缘 ,层厚 3～ 5mm连续扫描。结果 :47例中发生于L5椎弓峡部 3 9例 ,L4者 7例 ,L3者 1例。各种CT征象发现率为 :环裂征占 96% ,椎体前移位征占 82 % ,双椎体征为 5 3 % ,椎管拉长征占 43 % ,双关节面征占 3 0 % ,葫芦征占 2 8% ,游移征占 11% ,磨旋征占 4%。结论 :环裂征是椎弓峡部裂的特征性表现 ;双关节面征及葫芦征发现率低 ,但特异性很高。椎管拉长征具有一定的诊断价值 ,其它征象无论其发现率大小 ,均是峡部裂的继发改变 ,不能做为确诊的直接依据。     

腰椎小关节退变的CT诊断(附100例分析)

目的：研究CT对腰椎小关节退变的应用价值。方法：对100例腰椎小关节进行CT扫描，采用骨窗＋软组织窗进行观察。结果：腰椎小关节退变的CT表现：骨性关节面增生硬化60例，凹凸不平22例，模糊10例，中断22例，消失5例。关节间隙变窄11例，消失4例，宽窄不均4例，增宽4例，真空征19例，关节腔内游离体4例。小关节变尖11例，骨赘形成44例，骨质增生硬化13例，肥大畸形7例，骨质结构紊乱9例，骨质疏松53例，骨质囊变32例。小关节脱位或对合不良5例，关节囊钙化36例，黄韧带钙化25例，椎间孔变窄5例，侧隐窝变窄3例。结论：CT薄层扫描，骨窗和软组织窗同时观察是提高腰椎小关节退变诊断准确率的有效方法。     

Extraspinal abnormalities identified on lumbar spine CT

Summary Retrospective review of 1517 lumbar CT examinations revealed extraspinal pathology in 22 (1.45%). Retroperitoneal tumors and lymphadenopathy as well as vascular, urinary tract and gynecologic abnormalities were identified. This study demonstrates the need to carefully evaluate the visualized portions of the abdomen and pelvis on all lumbar spine CT examinations even when the patient's symptomatology is suggestive of spinal abnormalities.     

Pitfalls in the computed tomographic evaluation of the lumbar spine in disc disease

Summary Computed tomography (CT) is an effective non-invasive method of evaluating the lumbar spine in cases of suspected disc disease. In over a 3-year period in a high volume neuroradiologic practice we have observed a number of pitfalls in the diagnosis of herniated nucleus pulposus which may lead to erroneous conclusions and therefore, decrease the overall accuracy of the examination. These pitfalls, and their implications are presented and discussed.     

TLIF手术治疗腰椎退行性滑脱

目的总结TLIF手术在腰椎退行性滑脱治疗中应用价值。方法应用TLIF手术治疗腰椎退行性滑脱12例。结果术后随访3-12个月,所有椎间融合器未见移位、松动,内固定无断裂、滑脱等并发症。术后JOA评分22-29分,平均28．2分,满意率91．7％。结论TLIF手术入路在椎管外,椎管内干扰小,避免术后椎管内瘢痕形成,具有固定牢固、卧床时间短、融合率高等优点。     

Pedicle marrow signal intensity changes in the lumbar spine: a manifestation of facet degenerative joint disease

Objective. Signal intensity changes in lumbar pedicles, similar to those described in vertebral body endplates adjacent to degenerated discs, have been described as an ancillary sign of spondylolysis on MRI. The purpose of this study was to determine whether pedicle marrow signal intensity changes also occur in association with facet degenerative joint disease. Design. Eighty-nine lumbar spine MRI examinations without spondylolysis were reviewed for marrow signal intensity changes in pedicles and vertebral bodies as well as for facet degenerative joint disease. Results. Five percent (46/890) of lumbar pedicles in 23 patients had marrow signal intensity changes. Ninety-one percent (42/46) of the abnormal pedicles had adjacent degenerative joint disease of the facets, while only 21% (189/890) of normal pedicles had adjacent facet degenerative joint disease (p<0.001). Eighty-nine percent (41/46) of the pedicles with marrow signal intensity changes had adjacent degenerative disc disease. Conclusions. Pedicle marrow signal intensity changes are not a specific sign of spondylolysis; they are commonly seen with adjacent facet degenerative joint disease in the absence of spondylolysis. Pedicle marrow signal intensity changes are probably a response to abnormal stresses related to abnormal motion or loading caused by the degenerative changes in the spinal segment. Received: 2 May 2000 Revision requested: 18 July 2000 Revision received: 25 August 2000 Accepted: 1 September 2000     

胸腺瘤的螺旋CT诊断

目的：评价CT对胸腺瘤的诊断价值。方法：对43例经临床、手术、病理证实胸腺瘤的CT表现进行回顾性分析。结果：侵袭性胸腺瘤23例,形态不规则,边界欠清晰,有不同程度胸膜和／或心包膜增厚、受侵,其中15例内部密度不均匀,实质部分呈轻-中度强化。非侵袭性胸腺瘤20例,形态规则,边界清晰,内部密度均匀,实质部分呈轻度均匀强化。结论：CT检查对胸腺瘤有较高的诊断价值,对指导临床治疗有重要意义。