腰椎小关节退变的CT诊断(附100例分析)

CT diagnosis of the degenerative changes in lumbar zygapophysis

目的研究CT对腰椎小关节退变的应用价值。方法对100例腰椎小关节进行CT扫描,采用骨窗+软组织窗进行观察。结果腰椎小关节退变的CT表现:骨性关节面增生硬化60例,凹凸不平22例,模糊10例,中断22例,消失5例。关节间隙变窄11例,消失4例,宽窄不均4例,增宽4例,真空征19例,关节腔内游离体4例。小关节变尖11例,骨赘形成44例,骨质增生硬化13例,肥大畸形7例,骨质结构紊乱9例,骨质疏松53例,骨质囊变32例。小关节半脱位或对合不良5例,关节囊钙化36例,黄韧带钙化25例,椎间孔变窄5例,侧隐窝变窄3例。结论CT薄层扫描,骨窗和软组织窗同时观察是提高腰椎小关节退变诊断准确率的有效方法。

Objective To investigate the usefulness of CT in detecting the degenerative change within lumbar zygapophysis.Methods CT scan of lumbar zygapophysis with degenerative change was performed in a hundred patients and their CT findings were observed by bone window and soft tissue window.Results CT findings of the degenerative changes within lumbar zygapophysis were found to be varied such as subchondral facets proliferation and sclerosis in 60 cases,uneven in 22,blurred in 10,broken in 22,disappeared in 5.articular cavity became into narrowing in 11,disappeared in 4,unequal in 4,widening in 4,vacuom sign in 19.intra-cavity free fragment in 4.Lumbar zygapophysis became into sharp in 11.Osteophyte formed in 44,bony proliferation and sclerosis in 13,hypertrophy in 7,bony structure's disturbance in 9,osteoporosis in 53,and bony cystic change in 32 cases.Except these.the degenerative changes within lumbar zygapophysis also included little joint's hemidislocation or abnormal alignment in 5 eases.calcification of joint capsule in 36,calcification of ligament flava in 25,narrowing of intervertebral foramen in 5,narrowing of lateral recess in 3 cases.Conclusion Thin slice CT scanning and observation combined bone window with soft tissue window can accurately diagnose the degenerative changes within lumbar zygapophysis.