16排螺旋CT扫描后处理在腰椎峡部不连的临床应用

目的探讨16排螺旋CT扫描后处理对腰椎峡部不连的诊断价值及手术治疗的指导意义.方法对30例腰椎峡部不连患者进行16排螺旋CT轴位薄层重建、最大密度投影(MIP)、多平面重建(MRP)、表面遮盖显示(SSD)及容积重建(VR),并进行相关分析;同时追踪手术治疗情况.结果30例患者重建后处理显示椎弓峡部不连56处,单侧椎弓峡部不连4例;双侧椎弓峡部不连26例;全部患者均经手术证实.单纯平扫仅显示22例42处椎弓峡部不连,两者对椎弓峡部不连的诊断有显著差异(P＜0.05).重建后处理显示微小裂隙5例,不完全裂隙4例,骨痂及骨赘形成25例,神经根受压27例,硬膜受压25例,侧隐窝狭窄10例,椎体滑脱17例,黄韧带肥厚23例.手术治疗中所有患者均根据16排螺旋CT图像显示的神经根受压情况及椎管、神经根管狭窄情况进行减压及固定.结论16排螺旋CT不但能对腰椎峡部不连做出准确的诊断,同时能为手术治疗提供全面直观的影像学信息.

Clinical Applicable Value of Image Retro- reconstruction with 16 -slice Spiral CT in Spondyloschisis of the Lumbar Spine

Objective To evaluate the diagnostic and clinical value of image retro - reconstruction with 16 -slice spiral CT( 16sCT) in the spondyloschisis of the lumbar spine. Methods Axial thin layer recnstruction,maximum intensity projection(MIP), multiplanar reformation (MPR), surface shade display(SSD) and volume redering( VR) image of spondyloschisis of lumbar spine were carried on and the CT images were relatively analysed. All cases were operated and followed - up. Results Four Cases were unilateral spondyloschisis and 26 cases were bilateral spondyloschisis in the combined findings included small crack (5) incomplete crack (4) , formation of hy-perostsis or osteotylus(25), stenosis of nereve root canal (27), stenosis of the latetral recess(25) , spondyloschisis (10), thickening of the ligament flava (23) were displayed in image retro - reconstruction. Only 42 spondyloschisis of 22 cases were displayed in image of routin axial scan. The diagnostic value of image retro - reconstruction with 16 spiral CT in the spondyloschisis of the lumbar spine outweigh the image of common CT. In term of compression of nerve root and stenosis of spinal canal and nerve root caral, all cases were carried on decompression and fixation. Conclusion 16sCT can not only correctly diagnosis spondyloschisis and provide objective information of image in selecting surgical treatment method.