CT图像测量在腰椎管狭窄症诊断中的应用

The Application of CT Image Measurement in the Diagnosis of Lumbar Spinal Stenosis

目的探讨CT图像测量的不同方法和指标对腰椎管狭窄症的诊断价值。方法采用CT图像分析系统测量80例腰椎管狭窄症患者和80例正常者L4/5、L5/S1两个椎间隙的椎管矢状径(APDC)、椎管面积(CAC)、椎管内切圆面积(ICA)、硬膜囊面积(CAD)和硬膜外间隙(LAC),对两组患者的测量结果及腰椎管狭窄症组测量结果与JOA评分的相关性进行统计学分析,筛选出最能客观反映腰椎管狭窄程度的CT测量指标,作为腰椎管狭窄症的诊断标准。结果腰椎管狭窄组L4/5及L5/S1两节段的APDC、CAC、ICA、CAD和LAC均显著小于正常组(P<0.01)。APDC、CAC、ICA、CAD和LAC对L4/5、L5/S1椎管狭窄的诊断符合率分别为73.19%、88.41%、92.02%、78.98%、96.37%和73.75%、87.23%、91.49%、78.72%、95.74%;且硬膜囊面积/椎管面积与患者JOA评分都有显著相关性。结论 CT图像测量在腰椎管狭窄症诊断中有助于腰椎管狭窄症的诊断,具有重要的应用价值。

Objective To investigate the diagnosis value of different methods and indicators of CT image measurement in lumbar spinal stenosis. Methods 80 eases with lumbar spinal stenosis and 80 normal people were measured by CT im- age analysis system. Measurement parameters included vertebral canal sagittal diameter （APDC）, spinal canal area （CAC） , spinal canal area of inscribed circle （ICA） , hard membrane pouch area （CAD） and epidural space （ LAC ） of two intervertebral disc spaces （ IA/5 and LS/S1 ） in CT scan. The measuring results of the two groups and statistical corre- lation with JOA score of the lumbar spinal stenosis group were analyzed. The measurement indicator of CT scan which could most objectively reflect the degree of lumbar spinal stenosis was selected as diagnostic criteria of lumbar spinal stenosis. Results The APDC, CAC, ICA, CAD and LAC of IA/5 and L5 / S1 in lumbar spinal stenosis group were significantly lower than those in the normal group （P 〈 0. 01 ）. The diagnostic accordance rate of APDC, CAC, ICA, CAD and LAC in L4/5 and I5 / S1 vertebral canal stenosis were respectively 73.19%, 88.41%, 92. 02%, 78.98%, 96. 37% and 73.75%, 87. 23% , 91.49% , 78.72% , 95.74% ; in addition, dura area/ canal＇s area had significant correlation with patients＇ JOA score. Conclusion CT images measurement with important application value contributes to the diagnosis of lumbar spinal stenosis.