B超与CT对腰椎间盘突出症的诊断价值

The diagnostic value of lumbar intervertebral disc hemiaion with B-mode and CT

目的探讨B超检查和CT检查对椎间盘突出症的诊断价值。方法 168例腰椎间盘突出症患者,应用B超检查,患者呈屈膝俯卧位,腰背部呈"驼峰背",纵切于棘旁1～2 cm处向中线作15°～30°自上而下、自下而上、从左到右两侧斜切向棘突基底部扫查,测量椎管上下径和前后径,腰椎间盘膨出或突出的大小、内部回声,并观测韧带有无增厚。结果 B超检测168例,其中腰椎间盘膨出症68例,腰椎间盘突出症93例,黄韧带增厚7例。CT检测168例其中腰椎间盘膨出症86例,腰椎间盘突出症73例,黄韧带增厚9例。两种检查方法对比,B超诊断符合率87.5%,CT诊断符合率85%,经统计学分析两者无明显差异(P>0.05)。结论 B超能检测腰椎棘突结构,显示椎管上下径、前后径,能清晰显示非骨性椎管大小及椎管变窄受压的病理改变,准确性高。

Objective To study the diagnostic value of lumbar intervertebral disc hemiaion with B - mode and CT. Methods 168 cases of lumbar intervertebral disc hemiaion were checked with B - mode, the patients with flexing knee joints and lateral position,＂ hump back＂ ,on the 1 -2 cm side of spinous processes, starting in 15 -30 degree direction, from up to down,down to up,and from left to right to the base of spinous processes,measured the vertical longitude and diastolic diame- ter, the halo sign of bulge and observe the ligament thickened or not. Results Of 168 cases tested with B - mode, 68 cases of lumbar intervertebral disc bulge, 93 cases of lumbar intervertebral disc hemiaion, 7 cases of ligamentum flavum thickened. With CT,86 cases of lumbar intervertebral disc bulge, 73 cases of lumbar intervertebral disc hemiaion, 9 cases of tigamentum flavum thickened,Campared with two methods, the diagnostic coincidence rate of B - mode was 87.5% and CT was 85%, without statistically significant difference （ P 〉 0.05 ）. Conclusion B - mode can measure the structure of spinous processes, detect the inner diameter and vertical longitude, and detect the structure of spinal canal and pathological changes of decompression of spinal canal clearly,