脊柱创伤的CT诊断

CT Diagnosis of Spinal Injuries

目的：评价ＣＴ检查对脊柱创伤的诊断价值，提出脊柱创伤后作ＣＴ检查的适应证。材料和方法：５３例脊柱创伤的病人均作了平片及ＣＴ检查，并对各种类型脊柱创伤的平片和ＣＴ征象进行了回顾性分析。结果：ＣＴ能清楚显示三柱解剖结构、骨性椎管情况及脊髓受压程度，提高了诊断正确性，并提出了对下颈椎及椎管横径变窄的诊断价值。结论：笔者认为每个脊柱创伤的病人应先作平片检查，当具有下列五种平片征象时应作ＣＴ检查：１．椎体前缘严重楔形变；２．椎弓根间距增宽；３．椎体后缘高度减低；４．脊柱后突畸形；５．椎体前后错位。此外，当临床上有截瘫和神经症状时，即使平片表现轻微，也是作ＣＴ检查的适应证。

Purpose: To evaluate the diagnostic value of CT examination of spinal injuries and clarify the indications of CT examination. Materials and Methods: 53 cases with spinal injuries were examined by radiography and CT. The radiograms and CT scans of evecy kind of these injuries were scrutinized retrospectively. Results: CT scan could demonstrate the structure of 3 columns, hony spinal canal, compression of spinal cord and making a correct diagnosis. We appreciated the significance of CT examinations to lower cervical spinal injuries and evaluated the significance of the narrowing spinal canal transverse diameter. Conclusion: We suggested evecy patient with spinal injury should be examined by radiography at first. When one or some of the following radiographic findings are presented, CT examination should be done. These findings included: 1. severe wedge distortion of the anterior part of a vertebral body; 2. increased internedicle distance;3. diminished height of the posterior part of a vertebral body; 4. kyphosis and distortion of the spinal column; 5. dislocation of vertebral bodies. Besides, when paraplegia and other neurological deficit appreared, CT examination should he taken even if there isn't any of the above-mentioned radiographic findings.