颈椎病的三维CT表现(英文)

The 3DCT Manifestation of Cervical Spondylopathy

目的 探讨三维CT(3DCT)在诊断颈椎病方面的价值。方法 采用 3DCT技术检查了 30 0例颈椎病患者。其中 ,神经根型 1 4 5例 ,椎动脉型 4 1例 ,脊髓型 4 0例 ,混合型73例 ,食管压迫型 1例。 3DCT观察颈椎病患者的颈椎骨质增生、椎间孔大小、椎动脉和颈椎骨质增生的关系、骨性椎管狭窄的改变。结果 2 1 .3%的患者有颈椎椎体骨质增生 ,4 2 .3%的钩突关节和 1 6 .2 %的小关节突柱有骨质增生 ,另外有1 2个小关节突有错位改变。在 1 4 5例神经根型颈椎病患者中 ,发现狭窄的椎间孔 4 38个。其中 ,C6 - 7和C5 - 6椎间孔狭窄占 81 .3%。椎间孔狭窄的原因有钩突关节骨质增生、椎间盘突出、椎体肥大、小关节突骨质增生Vu错位等。椎动脉型颈椎病表现为骨赘压迫椎动脉 (2 2 .0 % )和椎动脉变细或粗细不均 (6 5 .9% ) ,1 2 .1 %的患者未见异常。脊髓型颈椎病3DCT表现有颈椎管狭窄、椎体后缘骨质增生、后纵韧带钙化、椎间隙狭窄和颈椎间盘突出等。结论 3DCT能全面评价颈椎间盘退变及其产生的颈椎骨质增生对神经、血管和脊髓的影响 。

Objective To study the value of three-Dimension Computer Tomograph (3DCT) in the diagnosis of cervical spondylopathy. Methods Adopt 3DCT technique to examine 300 patients who are clinically diagnosed as cervical spondylopathy, which contain 145 nerve root form cases, 41 vertebral artery form cases, 40 myeloid form cases, 73 mixed form cases and 1 esophageal compression form patient. And observe the cervical vertebral hyperosteogeny, size of intervertebral foramen, the correlation between vertebral artery and spondylopathy hyperosteogeny, the alteration in the osseous spinal canal stenosis with 3DCT. Results 21.3% patients have hyperosteogeny in the cervical vertebral body, 42.2% and 16.2% patients respectively have hyperosteogeny in the uncinate process articulation and zygapophysis, in addition, 12 zygapophysises have been dislocated. In 145 cases of nerve root form patient, stenosis is found in 439 intervertebral foramen, of which C6-7 and C5-6 intervertebral foramen stenosis account for 81.3%. The causes of intervertebral foramen stenosis are uncinate process articulation hyperosteogeny, intervertebral disc protrusion, vertebral body hypertrophy, zygapophysis hyperosteogeny, dislocation et al. Vertebral artery form cervical spondylopathy is manifested as the compression of vertebral artery (22.0%) by osteophyte and thinning or thickness difference of vertebral artery, 12.1% patients demonstrate no abnormality. The 3DCT manifestation of myeloid form cervical spondylopathy includes cervical spinal canal stenosis, hyperosteogeny of posterior vertebral body edge, posterior longitudinal ligament calcification and cervical intervertebral disc protrusion et al. Conclusion 3DCT could comprehensively evaluate the effect of cervical intervertebral disc regression and cervical vertebral hyperosteogeny on the nerve, blood vessel and spinal cord, it is a practical image examination method for the diagnosis of cervical spondylopathy.