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。     

退变性腰椎滑脱的CT分折

目的 探讨退变性腰椎滑脱的病因和CT诊断价值。方法 回顾性分析了50例退变性腰椎滑脱的CT表现，好发部位及其原因。结果 滑椎下缘相邻间盘均显示有“假性间盘脱出”征，椎间盘及椎小关节退变，椎小关节半脱位，硬膜囊受压。结论 椎间盘及椎小关节退变及韧带的松弛是本病的重要诱因，CT不仅能诊断退变性腰椎滑脱症，还能显示硬膜囊和神经根的改变。     

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。     

腰椎小关节退变的临床CT诊断分析

目的：分析探讨腰椎小关节退变临床CT诊断价值。方法选取近年来收治的109例腰椎小关节退变患者作为研究对象,所有患者均行CT检查诊断,就其临床诊断资料进行了回顾性分析。结果109例腰椎小关节退变经CT检查发现198个小关节发生病变,包括61个关节突增生肥大、48个关节腔真空、21例关节脱位或不稳、42个关节囊钙化、有63个关节膨出,81个椎间盘突出,其它征象包括关节面骨皮质硬化、关节间隙狭窄等。结论采用CT技术诊断腰椎小关节退变可以为腰椎关节疾病临床诊治提供全面、系统的信息指导,诊断价值极高。     

腰椎滑脱的平片及CT诊断

目的：提高对腰椎滑脱影像征象的认识。方法：常规X线正侧位片及CT扫描对腰椎滑脱的原因进行分析。结果：腰椎滑脱多为峡部裂及椎小关节病引起，14例峡部裂表现为环裂征及双面征。54例椎小关节病表现为椎小关节增生、肥大、关节局部变窄，关节间隙内“真空”现象，关节面囊性变，小关节半脱位等。滑脱主要表现为椎管矢状径增大，叠椎征，葫芦状改变，以及椎间盘假性膨出等。结论：X线正位片对诊断腰椎滑脱价值不大，侧位片能较为清楚地显示滑脱及程度，CT不仅能明确诊断而且可以提供更多信息，不失为目前腰椎滑脱的最佳诊断方法。     

腰椎相关结构的退变规律

目的 研究腰椎退变患者腰椎骨质、椎间盘、韧带、椎小关节退变及腰椎退变性失稳与年龄、性别的相关性,探讨腰椎退变规律.资料与方法 对1 180例腰椎退变患者的腰椎CT进行分析,观察不同年龄段、不同性别间椎体骨质、椎间盘、椎小关节、韧带退变以及退变性腰椎失稳的发生率.结果 腰椎退变患者腰椎间盘的退变率最高,其次是腰椎骨质、椎小关节、韧带、腰椎失稳.以36岁为年龄分界,36岁以下为腰椎低退变率年龄,以上是腰椎高退变率年龄,不同结构伴随年龄增长的退变率并不是同步递增的,腰椎骨质、椎小关节、韧带退变率及腰椎失稳发生率最高在65岁以上年龄段,而腰椎间盘退变率最高在36～45岁年龄段.男性腰椎间盘、骨质的退变率明显高于女性;椎小关节、韧带的退变率在男、女性间无显著差异;而女性腰椎失稳率明显高于男性.结论 总体上伴随年龄增长的腰椎退变,其不同结构的退变规律不一,在不同年龄段及性别间都存在明显差异,全面分析腰椎退变的影像表现有利于对腰椎退变性疾病的理解和治疗.     

腰椎间盘与椎小关节退行性改变的CT影像探讨

目的探讨腰椎间盘退行性改变及椎小关节进行性改变的CT影像特点。方法对52例腰椎退行性改变的患进行CT扫描，分析其椎间盘、椎小关节、韧带的CT表现。结果腰椎问盘的退行性改变的CT影像可表现为椎间盘的膨出、突出、髓核脱出及真空现象。椎小关节的退行性改变的CT影像可表现为关节突的增生肥大、骨形成、关节间隙变窄及关节面下囊样变。本52位患中，表现为椎间盘退行性改变占11.5％，表现为椎小关节的退行性改变占28.8％，腰椎间盘与椎小关节均受累占48.1％。结论椎小关节的退行性改变是腰椎间盘的退行性改变的早期征象。     

腰椎退行性病变CT分型(附1180例分析)

目的综合分析腰椎退行性病变的CT表现。方法分析1180例退变性腰腿痛患者的腰椎CT表现,按腰椎相关结构对其表现分类,结合临床表现,对腰椎退变的影像表现进行分型诊断。结果腰椎退变存在6种类型,即:椎间盘退变型,退变率65.3%;骨质退变型,退变率48.1%;椎小关节退变型,退变率36.0%;韧带退变型,退变率25.4%;退变性腰椎管狭窄,退变率44.0%;退变性腰椎失稳,退变率25%。前4种为原发性腰椎退变型,后2种为继发性腰椎退变型。结论腰椎退行性病变的CT分型有利于临床治疗。     

成人腰椎小关节退变的CT诊断与临床分析

腰腿痛是临床上的常见病、多发病．常发生在30岁以后。引起慢性腰腿痛的主要原因是腰椎的退行性改变。因此．在临床诊治过程中不能仅注重椎间盘突出症．而忽略椎小关节退变引起的临床症状。笔者搜集近两年来的56例腰椎小关节退变的CT与临床资料进行分析探讨。     

腰椎小关节退变的CT诊断及分析

目的：评价CT对腰椎小关节退变的诊断价值。材料与方法：对86例小关节退变的CT表现进行回顾性分析，其中男性57例；女性29例。年龄28—76岁，平均46．5岁。结果：CT所见异常征象为①小关节突的异常增生、肥大及骨赘的形成。②关节间隙变窄及其骨赘导致的侧隐窝、椎间孔及椎管的狭窄。③小关节腔内的积气现象。④小关节不对称及关节失稳。结论：小关节退变发生率高，CT可充分显示其解剖结构及病理改变，对该病的诊断具有重要意义。     

The lumbar facet joint: a review of current knowledge: part 1: anatomy,biomechanics, and grading

We present a two-part review article on the current state of knowledge of lumbar facet joint pathology. This first article discusses the functional anatomy, biomechanics, and radiological grading systems currently in use in clinical practice and academic medicine. Facet joint degeneration is presented within the larger context of degenerative disc disease to enable the reader to better understand the anatomical changes underlying facet-mediated lower back pain. Other less-common, but equally important etiologies of lumbar facet joint degeneration are reviewed. The existing grading systems are discussed with specific reference to the reliability of CT and MR imaging in the diagnosis of lumbar facet osteoarthritis. It is hoped that this discussion will stimulate debate on how best to improve the diagnostic reliability of these tests so as to improve both operative and non-operative treatment outcomes.     

CT诊断腰椎小关节综合征的价值

目的分析腰椎小关节综合征的CT表现,探讨CT对该病的诊断价值.材料和方法回顾性分析59例腰椎小关节综合征的CT表现.结果腰椎小关节综合征小关节异常主要包括小关节增生肥大、骨赘形成、关节间隙变窄、小关节真空现象,小关节半脱位、关节囊钙化及两侧小关节不对称以及侧隐窝狭窄,椎间盘真空征及轻度腰椎退行性滑脱.结论CT扫描可对腰椎小关节综合征诊断提供可靠影像学依据,对改进临床诊断和治疗腰腿痛有重要意义.     

腰椎椎间关节退变的CT表现及临床意义

目的加强对腰椎椎间关节退变的认识和重视。方法总结60例腰椎椎间关节退变的cT表现,所有病例均行常规cT平扫,层厚、间隔均为3-5him。结果CT扫描表现为：31例关节面不对称,58例关节突增生硬化、骨赘形成,45例关节间隙狭窄、糜烂、软骨下骨质改变,11例关节出现真空现象,12例关节囊及关节周同钙化（12例）。结论CT能对椎间关节退变作令面观察,对下腰痛患者．很有必要做cT检查以排除腰椎问关节退变。     

The relationship between the prevalance and size of lumbar ossified ligamentum flavum and the presence and degree of facet joint degeneration

Objectives

To investigate whether there is any relationship between the prevalence and the dimension of OLF and the presence and degree of facet joint degeneration. In addition, it revealed the prevalence and distribution of lumbar OLF with regard to age and spinal levels.

Methods

The stone protocol abdominal CT images of 114 patients were retrospectively analyzed. Presence of OLF, degenerative changes in the posterior vertebral elements was evaluated on axial CT images and incidence for each finding was determined. Additionally, the degree of facet joint degeneration and size of OLF was evaluated and recorded. All findings were also grouped based on age and lumbar level.

Results

OLF has been observed in 40 (35%) individuals at 76 (13%) lumbar levels. OLF has been most frequently encountered at the upper lumbar levels. Its frequency and size showed correlation to increased age. Frequency of OLF correlated with the presence of degenerative changes of in the posterior elements (p < 0.001). There was an association between the OLF size and the presence (p = 0.001) and degree of the degeneration in the posterior elements. There was no lumbar level case where the degree of OLF would lead to enough narrowing to be symptomatic.

Conclusions

OLF prevalence and sizes increase parallel to age. Posterior elements’ degenerative changes facilitate OLF development. A close relation exists between OLF size and facet joint degeneration. A direct relationship exists between OLF size and the degree of posterior elements degeneration. It is highly probable for lumbar level OLF size to be insufficient to cause any symptoms.     

腰椎退变性(假性)滑脱的CT诊断与鉴别诊断

目的研究腰椎退变性滑脱的CT特征,使之与腰椎峡部裂引起的真性滑脱鉴别。方法对80例无腰椎外伤史和腰椎椎弓峡部裂史腰椎退变性滑脱的CT资料作回顾性分析。CT扫描范围从滑脱椎体椎弓开始至下位椎体上缘,所扫层面与椎间盘平行。结果 CT扫描有以下特征:①椎间盘退行性改变。②椎骨和椎小关节退行性改变,腰椎椎体边缘骨质增生及腰椎骨质疏松,椎小关节面增生硬化、关节面下囊变、碎裂、关节间隙变窄或不对称和关节囊钙化;滑脱腰椎椎弓完整,椎体及附件整体向前(后)移位,向前滑脱时,滑脱椎体下关节突向前移位,其前缘几乎与下位椎体上椎小关节突前缘相平或超出下位椎体上椎小关节突前缘,关节方向向矢状方向转化。③椎管、椎间孔和侧隐窝狭窄。④终板双重轮廓。结论腰椎退变性滑脱有其CT特征,能与腰椎峡部裂引起的真性滑脱鉴别。     

腰椎峡部裂MSCT双倾斜重建技术的诊断价值

目的:研究MSCT双倾斜重建技术在腰椎峡部裂诊断中的方法与价值。方法:32例腰椎峡部裂患者经16排螺旋CT扫描后进行了双倾斜多平面重建及容积重建。结果:MSCT双倾斜重建技术能清楚显示腰椎峡部的正常解剖结构和腰椎峡部裂的CT征象,其主要的影像表现有"环裂征"、"双关节征"、"多关节征"、椎管矢状径增大、局部骨质增生硬化、腰椎滑脱、椎间盘变性、椎小关节退变等。以手术结果为金标准,MSCT双倾斜重建技术对32例腰椎峡部裂的诊断准确率为93.8%,常规轴位的诊断准确率为68.8%,前者的诊断准确率明显高于后者(P<0.05)。结论:MSCT双倾斜重建技术能直观地显示峡部裂的影像特征,具有较好的临床应用价值。     

Lumbar facet joint tropism does not accelerate degeneration of the facet joints.

PURPOSETo study the relationship of lumbar facet joint tropism to degeneration of the cartilage and subcortical bone in the facet joints and the effect of tropism in intervertebral disk degeneration.METHODSThe orientation of 104 cadaveric lumbar facet joints with respect to sagittal plane was measured on CT scans, and the joints were classified as having no tropism, mild tropism, or severe tropism. On MR images, the severity of cartilage degeneration and bony sclerosis was measured. The correlation between tropism and degeneration was calculated, as was the relationship among age, spinal level, and degeneration.RESULTSWe identified four spinal levels with severe tropism, six with moderate tropism, and 94 without tropism. Cartilage degeneration was not significantly more severe in the joints with tropism than in the joints without. Sclerosis was slightly greater in the joints with tropism than in the joints without it. Sclerosis and cartilage degeneration were significantly related to age and spinal level.CONCLUSIONAge, spinal level, and overall facet joint angle are more important factors in facet joint degeneration than is tropism.     

脊椎滑脱的影像学研究

脊椎滑脱病因主要有:先天发育不良、椎弓峡部裂、退行性变,其申后者最多见。真性滑脱主要是指椎弓峡部裂,假性滑脱主要包括退行性腰椎滑脱和先天发育不良性滑脱。大多数脊椎滑脱没有症状,患者脊椎稳定性较差时出现疼痛。平片侧位、左右斜位对病因诊断十分重要,但定性诊断率较低;叨横断面对椎弓峡部裂的检出有作用,但易将峡部裂隙与正常小关节间隙混淆而漏诊;椎弓反角度扫描技术有利于更好的显示和检出椎弓峡部裂,但需另行扫描,增加扫描次数和剂量;多层CT可一次各向同性扫描后采用多平面重组的后处理技术,在不增加扫描剂量的前提下,获得所有椎体椎弓及小关节横断面图像、斜横断(椎弓反角度)图像和矢状位图像等多种图像,从各种角度,特别是矢状长轴断面明确显示小关节及惟弓峡部状态,便脊椎滑脱的影像学研究提高了一大步。     

MR T2?mapping定量分析腰椎小关节退变关系研究

目的 探讨MR T2?mapping成像技术在定量分析腰椎小关节退变中的可行性及应用价值.方法 收集因慢性腰痛来本院就诊的患者51例及健康志愿者17例,采用3.0T MR对L1~S1腰椎小关节进行扫描,获取T2 WI及T2?mapping横断位图像,分别用于小关节形态学分级及关节软骨T2?值测定,行数据统计分析.结果 病例组与对照组小关节软骨T2?值差异无统计学意义(P>0.05);病例组不同Weishaupt分级的小关节软骨T2?值的单因素方差分析提示:0级与1级、0级与2级小关节软骨T2?值间均有显著性差异(P=0.001),0级与3级、1级与2级、1级与3级、2级与3级间小关节软骨T2?值间均无显著性差异(P>0.05).结论 MR T2?mapping成像技术在定量评价腰椎小关节早期退变中具有提示性价值.