螺旋CT多功能重建方式对腰椎峡部裂的诊断价值

Clinical application of spiral CT multi- reconstruction mode in diagnosing lumbar spondyloschisis

目的探讨螺旋CT(SCT)不同重建方式对腰椎峡部裂(spondyloschisis,SS)的诊断价值。方法对32例腰椎峡部裂行容积扫描后,进行表面重建(SSD)、多方位多平面重建(MPR)、改良法最大密度投影(MIP)等后处理,并由2位有经验的高年资放射科医生将获得的图像进行比较、分析。结果SSD显示SS20例22处及14例椎体滑脱,图像立体感强,解剖关系清晰;SSD结合切割(cut)及任意剖面技术,观察SS裂隙及局部骨痂、骨赘等细节,弥补了SSD只能显示感兴趣区表面改变的不足,进一步提高了对较小SS裂隙的显示率。MPR包括矢状位重建、冠状位重建、平行于椎板的左右斜位重建、沿椎管曲面重建(CPR)、平行椎弓轴线的反角度轴位重建(reversangleaxialreconstruction,RAAR)等,能显示全部32例73处SS及全部14例椎体滑脱;利用MPR的任意窗口技术可以分别显示局部骨质和软组织改变,并可对病变进行准确测量。MIP及其多角度投影技术、改良法切割技术,可以多方位、立体直观显示全部SS及其形态、走向、局部骨质改变等。结论螺旋CT多功能重建方式相互匹配是诊断SS的最佳方案,具有重要的临床应用价值。

Objective To study the clinical value of spiral CT multi - reconstruction mode in diagnosing lumbar spondyloachisis（SS）. Methods 32 cases （22 males and 10 females） were＇performed with axial volume scans and then all axial images were postprocessing with surface shade display （SSD） , muhiplanar reconstruction （MPR） and maximum intensity projection （MIP） and all images were retrospeetively analyzed by two experienced radiologists . Results SSD display SS 20 cases（22 sites） and all 14 cases lumbar olisthy with stereoscopical effect. SSD combining cut technique and every anatomic plane technique can significantly improve the displayed rate of smaller SS . MPR including sagittal reconstruction, coronal reconstruction , oblique reconstruction, curved - planar reconstruction （CPR） and reverse angle axial reconstruction （RAAR） could entirely reveal 32 cases（73 sites） ss and all 14 cases lumbar olisthy . Every windows technique could respectively display different tissues. The lesions could be accurately measured on MPR images. MIP images with multiangal projection technique and modified cut technique could stereoscopically display all lesions . Conclusion The matching of spiral CT multi - reconstruction mode is the best project in diagnosing SS and plays an important role in clnical management.