腰椎软骨结节的多层螺旋CT分型及临床意义

目的提高对腰椎软骨结节的认识,探讨多层螺旋CT多平面重组对本病的分型及其临床意义。方法回顾性分析85例经16层螺旋CT机容积扫描的腰椎软骨结节患者,并进行多平面重组,最后由2名有经验的CT诊断医师进行评价。结果85例腰椎软骨结节分为椎体中央型、椎体前缘型和椎体后缘型（LMPN）三种类型。CT表现为椎体局部骨质缺损,其内有椎间盘密度充填,周边骨质硬化。椎体中央型46例70个结节;椎体前缘型15例15个结节;椎体后缘型（LPMN）24例24个结节,均伴发椎体后缘离断,硬膜囊及神经根容易受压,18例继发椎管狭窄。结论MSCT能明确腰椎软骨结节的分型与诊断,椎体中央型与椎体前缘型软骨结节多无临床意义,而椎体后缘型（LPMN）常继发椎体后缘离断与椎管狭窄,临床症状明显,MSCT对制订手术方案具有重要指导意义。

Multislice spiral CT type and its clinical implications of lumbar vertebral cartilaginous node

Objective： To improve the knowledge of lumbar vertebral cartilaginous node and discuss its type and clinical implications in patients with lumbar vertebral cartilaginous node by using multislice spiral CT（MSCT） Multiplanar reformation（MPR） technique.Methods： Eighty-five cases with lumbar vertebral cartilagionous node were analyzed retrospectively.All cases were performed in conventional lumbar vertebral CT volume scan by 16-slice spiral CT and processed using multiplanar reformation（MPR）.At last,all the MPR images were observed and analyzed by two experienced radiologists.Results： The MSCT manifestations of cartilagionous node of lumbar vertebral body： There were bony defect filled with disk material and sclerosis on the cartilagionous node edge.According to the locations of lumbar vertebral cartilaginous node,three types were proposed： There were 46 cases with 70 nodes in type of lumbar vertebral central,15 cases with 15 nodes in type of lumbar interior marginal,24 cases with 24 nodes in type of lumbar posterior marginal（LPMN）,in which node posterior edge separation of lumbar vertebral body was found,dural sacs and spinal nerve roots were easily pressed and 18 of 24 nodes lead to stenosis of spinal canal.Conclusion： MSCT can display the type of lumbar vertebral cartilaginous node,the type of lumbar vertebral central and interior marginal mostly have no clinical implications.However,LPMN ofen causes posterior bonyedge separation of the vertebral body and spinal canal stenosis,their clinical symptoms of which are serious,and MSCT has significant value in surgical planning for LPMN.