老年腰椎退行性病变螺旋CT表现及诊断

The Study Of Multi-slice Spiral CT In the Spinal Degenerative Diseases

目的总结腰椎退行性病变的多层螺旋CT(MSCT)表现。方法300例诊断为腰椎退行性变的老年患者经MSCT扫描,分别行MPR、VRT、SSD三维重建图像,分析图像表现及不同重建方法的应用价值。结果老年腰椎退行性改变表现为椎体骨质增生、椎间盘膨出、椎间盘突出、"真空现象"、椎小关节病变、周围型的侧隐窝狭窄、退变性脊椎滑脱等。MPR可从轴位、冠状位、矢状位及任意角度的斜位重建同样高质量图像,较好地观察脊柱曲度、椎间盘病变、椎小关节、椎管内及椎间孔改变及椎体边缘性骨质增生;VRT及MPR可从不同角度观察腰椎弓峡部骨质状况、椎体边缘骨质增生;SSD在显示脊椎椎体边缘骨质增生方面效果好,与VRT效果相当;并可以进行三维测量。结论MSCT容积扫描所得薄层轴位图像结合应用三维重建技术所得的三维重建图像能明确反映腰椎退行性病变各种影像变化,综合应用以上各种重建方法有利于全面、准确地诊断及评价脊柱退行性病变。

Objective To discuss the diagnosis of multi-slice spiral CT（MSCT） of spinal degenerative diseases. Methods 300 cases of spinal degenerative diseases were studied. All patients were performed MSCT scan and images were reconstructed by multiplanar reconstruction （MPR）, volume rendering technique（VRT）,surface shaded display（SSD）. Results MPR was used to rconstruct the same high quality images for cross section,sagittal view,coronary view and oblique plane. The cervical unciform process hyperplasia,inter vertebral disc diseases,vertebral canal stricture, were showed well with MPR. VRT and MPR could show the finding osteo-hyperplasia of vertebral rims etc. from different angles. SSD was good for displaying the ostec-hyperplasia of vertebral rims, and its effect wasequivalent to VRT. Conclusion the spinal degenerative diseases can be evaluated comprehensively and accurately by using these reconstruction ways synthetically.