颈椎后纵韧带骨化症的CT表现

目的探讨颈椎后纵韧带骨化症（OPLL）的CT表现及其诊断价值。方法回顾性分析2004年11月2009年10月收治的6480例颈椎患者的CT图像资料,观察后纵韧带骨化块的形态、位置及与椎管的关系,计算椎管狭窄率。结果 6480例颈椎CT图像中,37例发现OPLL,占0.57%（37/6480）。颈椎后纵韧带骨化块表现为点状、条状、线状、平板状、山丘状、蕈伞状及花边状,呈现局限型、节段型、连续型、混合型特点。C4、C5及C6为颈椎后纵韧带骨化常见位置。骨化块平均厚度为4.12mm,骨化块致椎管矢状径狭窄率为10.20%～49.18%,多位于椎管前方中间位置。椎管狭窄率〉34.10%,临床症状明显。结论 CT检查能较好地显示颈椎后纵韧带骨化块的特征及椎管的狭窄程度,是临床医生选择手术方案和术后评估预后的一种较好方法。

CT Manifestations of Ossification of Posterior Longitudinal Ligament in the Cervical Spine

Objective To study the CT manifestations of ossification of posterior longitudinal ligament（OPLL） and to evaluate diagnostic value.Methods Retrospective analysis was made on the cervical spine CT images of 6 480 cases,and 37cases of OPLL were found.The shape,location of the ossification pieces and the sagital diameter of cer-vical spinal canal and the stenotic rate were observed and measured.Rusults The ossified pieces were manifested as dots,belts,lines,boards,mounds,mushrooms and flower margins in shape.They were continuous,segmental,solitary or mixed.OPLL usually was found at C4,C5and C6.The average thickness of the ossified pieces was 4.12mm. The spinal stenotic rate ranged from 10.20%to 49.18%due to OPLL.The ossified pieces were often found at the middle of the back edge of cervical vertebrae bodies.There were obvious symptoms when the stenotic rate of sagital diameter of cervical spinal canal was over 34.10%.Conclusion CT is an optimal modality for diagnosis of OPLL of cervical spine and cervical spinal stenosis,and may help the clinicians to select or valuate operation project.