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。

Imaging study of spondylolisthesis

The main causes of spondylolisthesis are deformation,spondylolysis and degeneration,and degeneration is the most common reason.Spondylolysis is called true spondylolisthesis.Whereas false spondylolisthesis includes degeneration and deformation of facet joint.Most of spondylolisthesis without clinical symptoms,few could feel pain when the spine is not steady.The lateral and double oblique view of X-ray plain film are of great importance for the diagnosis of spondylolisthesis,but true diagnosing rate is very low.The transverse images of CT is of some value for the detection of spondylolisthesis,but the fissure of spine arch in the isthmus is usually misdiagnosed as normal facet joint space.Opposite-angle scan technique of CT is useful to a better display and detection of spondylolysis,but it is a extra scan,and it adds a additional scan and increases X-ray dose of patients received.By multi-slice CT we can get transverse images,oblique transverse images(opposite-angle images) and saggital images of all the spine body and arch without adding patient radiation dose using multi-planar reformation processing technique on the bases of only once isotropic scan.Especially the saggital long axial image can clearly show the state of facet joint and arch isthmus,and the study level of spondylolisthesis imaging is improved a large step.