多层螺旋CT后处理重建在腰椎峡部裂诊断中的可行性研究

Feasibility of MSCT with postprocessing reconstruction in the diagnosis of lumbar spondylolysis

目的确定多层螺旋CT后处理重建技术在腰椎峡部裂诊断中的可行性。方法 31例临床怀疑腰椎峡部裂患者均经多层螺旋CT容积扫描。将原始数据传送至工作站进行MPR、SSD和VRT图像重组。结果本组31例中,双侧与单侧腰椎峡部裂分别见于29(93.5%)例和2(6.5%)例,其中,L5椎体25例(80.6%),L4椎体5例(16.1%),L3椎体1例(3.2%);L4与L5椎体同时受累者4例(12.9%)。本组31例共检出64处椎弓峡部裂病灶。典型的"双关节征"和"裂隙征"见于所有病例。腰椎峡部裂伴发腰椎滑脱和隐性骶椎裂分别见于12和1例。MPR和VR对腰椎峡部裂的显示优于SSD,然而,SSD能清晰显示椎体滑脱。结论多层螺旋CT,尤其是MPR和VR对腰椎峡部裂的诊断具有高度敏感性,可作为首选的影像技术。

Objective To determine the feasibility of MSCT with postprocessing reconstruction in the diagnosis of lumbar spondylolysis（LS）.Methods Thirty-one patients with clinically suspected LS underwent MSCT volume scans.The source images were transferred into the workstation and reconstructed by using MPR,SSD and VRT.Results Among 31 patients,unilateral and bilateral LS lesions were found in 29（93.5%） cases and 2（6.5%） cases,respectively,of whom,25（80.6%） cases at L5,5（16.1%） cases at L4,and 1（3.2%） cases at L3.Coexistence of L4 and L5 involvement was found in 4（12.9%） cases.There were 64 LS lesions in 31 patients.The typical dual-articular signs and fissure signs were found in all patients.LS lesions associated with vertebral body slippage and occult sacrovertebral bifida were found in 12 and 1 case,respectively.MPR and VRT in visualizing LS were superior to SSD,while SSD could clearly show the vertebral body slippage.Conclusion MSCT,especially MPR and VRT have high sensitivity for diagnosing LS,so that these postprocessing techniques should be taken as first choice to diagnose this disease.