多层螺旋CT重组技术在髓核溶解术治疗椎间盘突出中的应用

Application of Multi-slice Spiral CT 3D Reconstruction in the Treatment of Intervertebral Disc Herniation Using the Myeloid Nucleus Dissolution Technique

目的探讨多层螺旋CT重组技术在椎间盘突出髓核溶解中的应用价值。资料与方法对本院36例CT引导下髓核溶解术治疗椎间盘突出患者,行多层螺旋CT扫描,薄层重组后行轴位、多平面重组(MPR)、最大密度投影(MIP)及三维容积再现(VRT)的影像后处理。结果术前MPR矢状位重组图像清楚地显示了突出地椎间盘类型:铆钉型23例(23/36),水滴型11例(11/36),游离型2例(2/36);轴位CT、MPR、MIP、VRT能清晰显示术后胶原酶在椎间盘及突出物中的分布状态、术中穿刺针的进针角度及深度。结论多层螺旋CT重组技术能清晰显示术前椎间盘突出形态、术中穿刺针角度、深度及术后胶原酶在椎间盘及突出物中分布情况,不但可提高对椎间盘突出诊断的准确性,而且对临床制定治疗方案、预测手术可行性及评估手术效果,具有很高的实用价值。

Objective To discuss the value of multi-slice spiral CT 3D reconstruction in evaluating the intervertebral disc myeloid nucleus dissolution. Materials and Methods 36 patients with intervertebral disc herniation underwent myelold nucleus dissolution treatment under CT guidance. Muhi-slice spiral CT scan and the post-processing reconstruction such as multiplanar reconstruction （MPR）, most density projection（MIP） and volume rendering technique （VRT） were performed. Results The type of the intervertebral disc herniation could be accurately displayed on MPR sagittal images： rivet in 23 cases （23/36） , water drop in 11 （11/36 ） and dissociation in 2 （2/36）. The distribution of collagenase in the intervertebral disc and the angle or depth of the puncture needle were also accurately displayed on axial CT, MPR, MIP and VRT images. Conclusion The shape of the intelwertebral disc herniation before operation, the angle or depth of the puncture needle during operation and the distribution of collagenase in the intervertebral disc after operation can be accurately displayed by multi-slice spiral CT 3D reconstruction. It can improve the accuracy of diagnosis, and also helpful to make treatment plan, forecast the feasibility of the operation and assess the effect of the operation.