螺旋CT三维重建诊断脊髓型颈椎病

Three-dimension Computerized Tomography in Diagnosis of Cervical Spondylotic Myelopathy

目的探讨三维CT对脊髓型颈椎病(cervicalspondyloticmyelopathy,CSM)的诊断价值。方法采用三维CT技术检查86例CSM,观察颈椎骨质增生和椎管的病理改变,测量椎管矢状径及Pavlov比率,评价椎管狭窄的程度。结果67·4%有颈椎椎体骨质增生,61·2%有钩突关节,27·9%有小关节突有骨质增生,39·5%有颈椎生理曲度改变。三维CT对脊髓型颈椎病椎管狭窄的病因表现为椎间盘突出77例(89·5%)、椎体后部缘骨质增生62例(72·1%)、黄韧带肥厚褶皱34例(39·5%)、后纵韧带钙化14例(16·3%)、小关节突骨质增生16例(18·6%)、椎板增厚15例(17·4%)、椎体滑脱10例(11·6%)。结论三维CT能对CSM作出准确、全面的评估,具有重要临床价值。

Objective To study the value of three- dimension computerized tomography （3DCT） in the diagnosis of cervical spondylotic myelopathy （CSM）. Methods＂＇ The 3DCT technique was used to examine 86 patients clinically diagnosed as CSM. The cervical hyperosteogeny and vertebral pathology were measured and the sagittal diameter of the vertebral canal and Pavlov ratio were determined to evaluate the degree of stenosis of the spinal canal. Results The hyperosteogeny in the cervical vertebral body was found in 67.4% patients, the hyperosteogeny in the uncinate process articulation and zygapophysis in 61.2 % and 27.9% patients respectively, and the change of cervical curve in 39.5 % patients. 3DCT showed that the causes of cervical vertebral canal stenosis of myeloid type cervical spondylopathy included 77 （89.5 % ） patients with intervertebral disc protrusion, 62 patients （72.1% ） with hyperosteogeny in the posterior edge of the vertebral body, 34 patients （39.5 % ） with hypertrophy of ligmenta flava, 14 patients （16.3 % ） with longitudinal ligament calcification, 16 patients （18.6 % ） with hyperosteogeny in the articular process, 15 patients （17.4 % ） with thickening of vertebral lamina and 10 patients （11.6 % ） with intervertebral dislocation. Conclusion 3DCT can evaluate CSM comprehensively and has important clinic value.