螺旋CT三维重建对颈椎狭窄症的术前评价

目的探讨螺旋CT三维重建对颈椎狭窄症术前的诊断价值。方法用螺旋CT对45例拟行手术治疗的颈椎狭窄症患者行薄层容积扫描，采用合适的重建参数及阈值在工作站上进行三维重建，多角度、多层面拍片。结果三维重建图像清晰显示颈椎椎管、横突孔及椎间孔的狭窄情况，45例患者中，其CT表现有椎体骨质增生(n=36)，骨质增生合并后纵韧带肥厚骨化(n=6)，椎问盘钙化(n=3)，横突孔狭窄(n=9)以及椎间孔不规则狭窄(n=24)。上述CT诊断均经病理证实。结论螺旋CT三维重建简化了观察者的思维过程，可直观地了解颈椎狭窄症的三孔立体空间的实际大小、形态、位置及周围组织的立体解剖显示，可为制订手术方案提供重要的信息。

Pre - operative evaluation of cervical spine stenosis using spiral CT three dimensional reconstruction

Objective To explore the value of spiral CT three dimensional reconstruction in the pre - operative evaluation of cervical spine stenosis. Methods Forty - five patients with cervical spine stenosis, which are going to receive the surgery underwent CT thin slice volumes scans. Three dimensional reconstruction was performed on work station with proper parameters and threshold. Multiangular and multi - layer photographs were taken. Results Thee dimensional reconstruction imaging clearly shown the stenosed extent of vertebral canal. transverse foramen and intervertebral foramen. CT findings seen in all patients included the bone proliferation of vertebral body(n = 36). the thickening and/or the ossification of ligamenta longitudinal posterius(n = 6), the calcification of intervertebral disk (n = 3 ), the narrowing of transverse foramen(n = 9) and the irregular narrowing of intervertebral foramen(n = 24). Above CT diagnoses have been demonstrated by the surgery. Conclusion CT imaging with three dimensional reconstruction greatly simplified the thinking course of the observers and vividly revealed the size, shape, location of the lesions and their spacial relation to the surrounding tissues therefore it can provide a number of important informations for diceding the surgical project of cervical spine stenosis