脊柱病变多层螺旋CT的应用价值

目的：探讨多层螺旋CT对于脊柱病变的诊断价值。方法：搜集脊柱病变患者18例，其中脊柱骨折7例，颈椎后纵韧带骨化2例，腰椎结核2例，特发性脊柱侧弯7例。所有患者经多层螺旋CT扫描，MIP、MPR／CPR、3D-SSD与4D-Angio重建，分析不同处理后图像的应用价值。结果：MRP／CPR应用简捷，可矢状、冠状观察骨性病变的部位与程度，但对于胸椎骨折或侧弯，由于受到肋骨重叠的显示而不适用于评价胸椎骨折；3D-SSD可观察骨性结构的破坏，但缺乏对椎管形态的显示，4维重建可清晰评价脊柱骨折与脊柱侧弯的所有相关表现，通过调节不同密度阈值可显示出椎管内形态，尤其适用观察骨折、侧弯的分类与椎管的状况。结论：多层螺旋CT可全脊柱扫描，其多种后处理技术的应用可全面评价脊柱病变，4维重建可清晰评价脊柱病变的所有相关表现，而MIP不适用于对脊柱的评价。

Evaluation of spine diseases with multiple-slice helical CT

Objective:To disscuss the value of multiple slice helical CT for diagnosis of spine diseases.Methods:18 cases with spine diseases,most of them were spine fracture,idiopathic scoliosis etc were studied.All patients were performed multiple slice CT scan and the images were reconstructed by maximal intensity projection (MIP),multiple/curved planner reconstruction (MPR/CPR),three dimension surface shading display (3D SSD) and four dimension angio (4D Angio) technique.The value of the various images for diagnosis was assessed.Results:MRP/CPR technique was easily used for sagittal and coronary,but not good for thoracic spine fracture or scoliosis because of overlapping of the rib;3D SSD could be used only for observing the changes of spine structure,not for displaying the spinal canal;4D angio could clearly show the shape,position and degree of spine fracture and scoliosis through adjusting different density threshold.Conclusion:MSCT can be used for scanning of the whole spine,various reconstruction techniques can evaluate spine diseases comprehensively,especially the 4D angio technique.