16层螺旋CT在颈椎病中医诊治中的应用

Study of 16 slice spiral CT in traditional Chinese medicine diagnosis and treatment of cervical spondylosis

目的探讨16层螺旋CT在颈椎病中医诊治中的价值。方法回顾性分析225例颈椎病患者的中医分型与多层螺旋CT影像表现。结果风寒湿型48例,多层螺旋CT影像表现为颈椎生理曲度变直或反张,椎小关节增生,韧带钙化;气滞血淤型62例,CT表现为颈椎间盘突出,椎间孔狭窄,神经根受压;痰湿阻络型78例,CT影像表现为骨性椎管狭窄,脊髓受压变形移位;肝肾不足型37例,CT显示横突孔狭窄,椎动脉扭曲狭窄;气血虚亏型13例,CT显示椎小关节对应不良,关节间隙出现真空,椎体失稳。结论 16层螺旋CT检查能够确定病变的部位和范围,明确显示椎管、椎间孔及横突孔的狭窄、神经根及脊髓的受压程度,可以观察椎动脉的变异、钙化及狭窄程度,能为颈椎病中医辩证分型提供客观指标,有利于提高颈椎病中医诊治效果。

Objective To discuss the value of the 16 slice spiral CT in TCM（traditional chinese medicine）diagnosis and treatment about cer-vical spondylosis. Methods Two hundreds and twenty five patients with cervical spondylosis in the TCM type and the performance of multi-slice spiral CT imaging were analyzed retrospectively. Results In 48 cases of the wind cold dam-pness type,the manifestations of multi-slice spiral CT images were cervical physiological curvature straightening or win-ding on the contrary,vertebral-joint hyperplasia,ligament calcification. In 62 cases of stagnation of vital energy and blood stasis type,the manifestations of CT were cervical disc herniation,intervertebral foramen stenosis,nerve root compression. In 78 cases of phlegmatic hygrosis and blocking collaterals,CT images showed bony narrowing of vertebral canal,spinal cords were metamorphotic and shifted by compression. In 37 cases of liverkidney deficiency type,CT images showed transverse foramen narrowing,stenosis of vertebral artery twist. In 13 cases vitalenergy deficiency type,CT images showed facet joint space corresponds to a bad,vacuum,vertebralinstability.Conclusion Sixteen slice spiral CT examination can determine the site and extent of the lesion,the degree of compression about the spinal canal,clearly display intervertebral foramen and transverse foramen stenosis,nerve root and spinal cord,can observe the vertebral artery variation,calcification and stenosis degree,can provide objective index for TCM dialectical type cervical vertebra disease,being conducive to the improvement of traditional Chinese medicine for the effect of diagnosis and treatment of cervical spondylosis.