多层螺旋CT及三维成像对老年颈椎椎管狭窄的诊断价值

目的探讨三维CT对老年颈椎椎管狭窄的诊断价值。方法对32例行颈部或颈椎检查的病人进行多层螺旋CT横断扫描，扫描后对图像行薄层重建，并传至工作站，应用轴位、多平面成像（MPR）、表面遮盖成像（SSD）、容积成像（VR）及仿真内镜（VE）等方法对有颈椎椎管狭窄的病例图像进行分析。结果32例患者中，18例患者颈椎椎管大小和形态正常，14例病人颈椎椎管均不同程度狭窄，通过不同形式的成像方式可以观察到病变，其中包括骨质增生和椎间盘脱出两种情况，在14例椎管狭窄的病人中，观察到骨质增生38处，颈间盘脱出8处；对于骨质增生的情况，在轴位像上观察到30处，冠状位像上观察到3处，矢状位像上观察到38处，三维图像上观察到21处，仿真内镜像上观察到15处，颈间盘脱出的表现仅能在轴位像上显示。结论多层螺旋CT及三维成像能提供老年性椎管狭窄的精细情况，对颈椎椎管狭窄能立体、直观、全面地展示其原因及程度，为临床治疗提供更充分的信息。

Application of MSCT and three-dimensions imaging in diagnosis of cervical spinal canal stenosis in the elderly

Objective To investigate the application value of MSCT and three-recon-struction in the diagnosis of cervical spinal canal stenosis in the elderly.Methods 32 patients were scanned transversely in cervical spine and reconstructed the images by GE Lightspeed 16 CT scanner.The patients images with cervical spinal canal stenosis were diagnosed with axial,multiple planar reconstruction(MPR),shade surface display(SSD),multiple planar volume rendering(MPVR),virtual endoscopy of vertebral canal(VEVC) etc.Results Cervical spines were normal in 18 patients and stenosis in 14 patients.38 lesions of hyperosteogeny and 8 lesions of disc protrusion associated.The axial images showed 30 lesions,the coronal images showed 3 lesions,the sagittal images showed 38 lesions,3D images showed 21 lesions and VEVC images showed 15 lesions.Cervical disc protrusion can only be showed with axial images.Conclusions MSCT and three-reconstruction can clearly show the information of cervical spinal canal stenosis in the elderly.It can show the reason of stenosis and observe extend of associated cervical disc protrusion directly,which can offer more useful information for clinical treatment.