椎管造影伴CT扫描在腰椎管狭窄症诊断中的作用

目的重新评价椎管造影伴CT扫描在腰椎管狭窄症诊断中的作用。方法对62例退行性腰椎管狭窄症（12例伴腰椎退行性侧弯，18例伴腰椎退行性滑脱，3例同时伴腰椎退行性侧弯和腰椎退行性滑脱）患者，术前采用CT、MRI和椎管造影伴CT扫描（椎管造影后同时摄动力位片）进行综合诊断，并与术中减压探查结果相比较。结景CT、MRI和椎管造影伴CT扫描的诊断一致率分别为68％，76％和83％，综合三项影像学结果，则诊断一致率为100％。椎管造影伴CT扫描在诊断腰椎管狭窄症伴腰椎侧弯及动力性腰椎管狭窄症时优于CT和MRI。结论椎管造影伴CT扫描检查尽管存在一定的并发症，但在腰椎管狭窄症诊断中仍起着重要的作用。

Re-evaluation of Upright Flexion-Extension Myelography and Computed Tomographic Myelography in Diagnosing Lumbar Spinal Stenosis

Objective To re-evaluate upright flexion-extension myelography and computed tomographic myelography in diagnosing lumbar spinal stenosis. Methods We combined CT,MRI with upright flexion-extension myelography and computed tomographic myelography to diagnose degenerative lumbar spinal stenosis in 62 cases,including 12 cases combined with degenerative lumbar scoliosis,18 cases with degernative lumbar spondylolisthesis,3 cases with degernative lumbar scoliosis as well as degernative lumbar spondylolisthesis before operation.The results were correlated with surgical findings. Results The average exactness rate of CT,MRI and upright flexion-extension myelography/computed tomographic myelography was 68%,76% and 83%,respectively.With combination of the(above) mentioned three tests,the exactness rate was 100%.The upright flexion-extension myelography and computed tomographic myelography was superior to CT and MRI in diagnosing lumbar spinal stenosis with scoliosis as well as dynamic lumbar spinal stenosis. Conclusion Though some complications occurred,an upright flexion-extension myelography and computed tomographic myelography still played important role in diagnosing lumbar spinal stenosis.