VR+CTA对脊柱变形患者的诊断及临床价值研究

The Diagnosis and Clinical Value of VR+CTA in Scoliosis

目的探讨脊柱变形的VR+CTA影像学特征及临床价值。方法回顾性分析2013年1月-2015年11月经我治疗的38份脊柱变形患者的VR+CTA影像学资料及临床资料病例。结果通过VR+CTA检查显示,脊柱侧弯、旋转病例降主动脉经上胸段椎体(T5-7)前缘迂曲绕行至椎体右前方,并于L2椎体前缘向左前方走行;椎体破坏(结核)伴有侧弯的病例具有下胸段椎体内骨质破坏、增生、椎体变形等征象,动脉经上胸段椎体凹入后凸椎体,向下方椎体延行。脊柱变形患者血管充盈良好,壁无钙化斑,管腔形态正常,未见狭窄、扩张及充盈缺损。38例患者进行VR+CTA检查后,均能对脊柱情况及周围伴行脏器进行清晰显示,包括脊柱变形的位置和血管的走向。结论VR+CTA影像学特征能有效诊断脊柱变形部位、程度及与周围结构的关系,有利于患者选择恰当的临床治疗方案和预后评估,值得临床进一步推广和应用。

Objective To investigate the VR＋CTA imaging characteristics and clinical value of scoliosis. Methods A retrospective analysis of 38 scoliosis patients＇ VR＋CTA imaging and clinic data from January 2013 to November 2015. Results The VR＋CTA examination demonstrated that the descending aorta of scoliosis and rotation cases detour from the upper thoracic vertebrae（T5-7） to the right front of the vertebral body. The vertebral destruction（TB） cases with scoliosis possess signs of bone destruction, proliferation and vertebral deformation in the lower thoracic vertebrae, and the artery of upper thoracic vertebrae deformed into kyphosis concave and extended to the lower part. The vascular of spine deformation patients fills well and there is no calcified plaque as well. Meanwhile, the formation of vascular is normal, without any stenosis, expansion and filling defects. After VR＋CTA examination of 38 patients, the situation of spine and its surrounding organs are clearly displayed, including the location of spinal deformation and vascular direction. Conclusion VR＋CTA imaging can effectively diagnose the location and extent of scoliosis, degree and the relationship with the surrounding structure which helps patients to choose the appropriate clinical treatment and prognosis and is worthy of further promotion and application.