硬膜外造影后MSCT扫描对腰神经根管狭窄的诊断研究

The Study of Epidurography and Multispiral CT Scanning Examination in the Diagnosis of Lumbar Nerve Root Canal Stenosis

目的分析硬膜外造影后多排螺旋CT扫描(epidurography and multispiral CT scanning,MSCTE)的影像学特点和对腰神经根管狭窄的诊断作用。方法自2007年12月至2008年10月共完成了MSCTE检查29例,26例完善了CT、MRI和MSCTE三项检查,26例中23例进行了手术探查。分析MSCTE的影像学特点,并与CT和MRI影像进行对比研究,对CT、MRI和MSCTE三种影像诊断试验评价的灵敏度、特异度和总符合率进行统计学分析。结果MSCTE能很好地兼顾腰神经根管的骨与软组织界限。CT、MRI和MSCTE诊断神经根管狭窄的灵敏度依次为76.5%、88.2%和94.1%;特异度依次为60.0%、60.0%和80.0%;总的符合率依次为72.7%、81.0%和90.9%。MSCTE对腰神经根管狭窄诊断灵敏度、特异度和总符合率高于CT和MRI。结论MSCTE有其独特的影像学特点,在诊断腰神经根管狭窄方面优于CT和MRI。

Objective To investigate imaging features of epidurography and multispiral CT scanning （MSCTE） and the role in diagnosis of lumbar nerve root canal stenosis. Methods There were 29 patients performed epidurography and multispiral CT scanning from December 2007 to October 2008,and among them 26 patients performed all the three examinations of CT,MRI and MSCTE. 23 patients were undergone surgical treatment. Compared with CT and MRI,the imaging features were investigated,and the sensitivity,specificity and total consistent rate were analyzed. Results MSCTE show the extent of soft tissue as well as bone. The sensitivity of CT,MRI and MSCTE is 76.5%, 88.2% and 94.1% ,specificity 60.0% ,60.0% and 80.0% ,total consistent rate 72.7% ,81.0% and 90.9% respectively for diagnosis of lumbar nerve root canal stenosis. Conclusion With excellent imaging appearance ,MSCTE is better than CT and MRI in diagnosis of lumbar nerve root canal stenosis.