破裂型腰椎间盘突出症的CT诊断

CT Diagnosis of Ruptured Lumbar Disc Protrusion

目的探讨破裂型腰椎间盘突出症ＣＴ表现。方法破裂型腰椎间盘突出症６８例，男性３０例、女性２８例，年龄２５～５０岁。ＣＴ征象进行分析。结果（１）髓核游离征：即髓核游离入椎管内；（２）重度突出症：即突出后缘超过椎管前后径的１／２，不整齐．与硬膜囊分界不清；（３）后缘锐角征：即突出后缘超过椎管前后经的１／２，边缘清能分辨硬膜囊，但突出后缘成锐角；（４）后缘上、下滑动征：即非椎间盘平面显示突出椎间盘影。结论ＣＴ分析得知髓核游离任和重度突出症是判断破裂型腰椎间盘突出症的可靠征象；后缘锐角征和后缘上、下滑动征尚需结合其他征象和临床表现作出进一步分析。ＣＴ能诊断破裂型腰椎间盘突出症，对治疗方法的选择具有指导作用。

To explore the CT presentations of ruptured lumbar disc protrusion. Methods CT presentations were are analyzed in 68 ruptured lumbar disc protrusion cases (male 40, female 28 aged between 25 to 50 years). Results The following CT presentations were revealed: (1) Freeing nucleus pulposus: the nucleus pulposus intruded into the vertebral canal; (2) Severe lumbar disc protrusion: The posterior border of the protruded part was over 1/ 2 the diameter of the vertebral canal with irregular edges and without clear boundary with the dural bursa; (3) Sharp posterior angle:The posterior border of the protruded part was over 1/2 the diameter of the vertebral canal with clear boundary with the dursa bursa, but the posterior border was in sharp angle; (4)The gliding sign of the protruded posterior edges.CT showed disc protruded not at the disc level. Conclusion The CT analyses revealed that freeing nucleus pulposus and severe lumbar disc protrusion were reliable diagnostic signs while sharp posterior angle or the gliding sign of the protruded posterior edges were of reference value in the diagnosis of ruptured lumbar disc protrusion. CT findings were of value in the diagnosis of ruptured lumbar disc Protrusion.