64排螺旋CT容积扫描及多种重建技术对腰椎椎弓峡部裂的诊断价值

目的探讨64排螺旋CT MPR、VRT、SSD重建技术在腰椎椎弓峡部裂诊断中的价值。方法 28例临床怀疑腰椎椎弓峡部裂患者均经64排螺旋CT容积扫描,将数据传输至工作站,采用轴位薄层重建及平行于左/右椎弓根方向的斜矢状位进行MPR、SSD和VRT图像重组后处理。结果本组28例中,双侧腰椎椎弓峡部裂24例(85.7%)、单侧腰椎椎弓峡部裂4例(14.2%);其中,L5椎体24例(85.7%),L4椎体3例(10.7%),L3椎体1例(3.5%);L4与L5椎体同时受累者2例(7.1%)。本组28例共检出54处椎弓峡部裂病灶。轴位图像上均见"环裂征",斜矢状位MPR图像能清晰直观地显示小关节和椎弓的"猎狗征"图像及峡部断裂形成的"断颈征",对椎弓峡部裂及其状态的显示及峡部裂断端是否有错位、是否有碎骨片及假关节形成等方面效果更好。结论多层螺旋CT尤其是MPR和VRT对腰椎峡部裂的诊断具有高度敏感性,可作为首选的影像技术。

The Value of the Volumetric CT Scanning in the Diagnosis of Lumbar Spondylolysis

Objective To discuss the va]ue of volumetric scanning with 64 row multi-slice CT（MSCT） in the diagnosis of lumbar spondylolysis（LS）. Methods twenty-eight patients who were clinically suspected of having LS underwent volumetric scanning with MSCT, then various post-processing techniques including multi-planar reformation（MPR） in oblique saggital angle and volume rendering technique （VRT）were carried out at the workstation. Result Among 28 patients, bilateral and unilateral LS lesions were found in 24 cases （85.7%）, 4 cases （14.2%） respectively; Among all these cases, 24 cases were at L5（85.7%）; 3 cases at L4 （10.7%）, 1 case at L3（3.5%）; 2 cases at both L4, L5;（7.1%）; Altogether 54 lesions in 28 patients. The typical fissure signs were found in all patients in axial scanning; The ＂courser sign＂ of vertebra small joint and arch and the ＂broken neck sign＂ in oblique saggital angle scanning; which position is better to the demonstration of disruption end in isthmus, dislocation of disruption end and pseudoarthrosis. Conclusion The images in axial thin layer reconstruction and saggital oblique angle MPR by using MSCT play an important role in diagnosis of lumbar spondylolysis.