CT神经同层显示技术对腰骶神经根变异的诊断价值

The CT nerve colayer display technology in diagnosing the variation of lumbosacral nerve root

目的：探讨CT神经同层显示技术对腰骶神经根变异（lumbosacral nerve root anomalies，LSNRA）的诊断价值。方法：顺序选取2015年10月~2016年5月在我院医学影像科因腰腿痛（除外腰椎术后、肿瘤或炎症引起疼痛者）而行腰椎CT检查的100例患者，男54例，女46例，年龄27~88岁（65.0±15.6岁）。采用Philips（Ingenuity CT）64排螺旋CT机行常规腰椎容积扫描，同时进行常规图像重组和神经重组（重组双侧L2神经根至S2神经根），并分别观察腰骶神经根形态。变异的神经根按坎贝尔骨科手术学的标准分为6型。结果：97例图像显示满意。常规图像（轴位、冠状位、矢状位）与神经重组图像各发现LSNRA 3例和13例，显示率分别为3.09%和13.40%，两者之间存在显著性差异（P=0.002）。在13例变异神经根中，Ⅱ型变异11例（84.62%），Ⅴ型变异2例（15.38%）。结论：CT神经同层显示技术可以完整、直观地显示神经根变异形态、走行及与相邻神经根的关系，是诊断LSNRA的一种较理想方法。

Objectives： To explore the practical value of CT nerve colayer display technology in diagnosing the variation of lumbosacral nerve root（LSNRA）. Methods： One hundred cases suffering from lumbocrural pain（patients with lumbar spine surgery, tumor or inflammatory excluded） in our unit from Oct 2015 to May 2016 were retrospectively studied（46 females and 54 males; age range, 27-88 years）. CT volumetric scanning, image restructuring and neural restructuring in lumber spine were done by Value of 64-row spiral CT（reconstructing on both sides of the nerve root from L2 to S2）. According to Campbell′s Operative Orthopaedics Clinical Symptom System, the variations of nerve root were divided into 6 types. Results： 97 cases got satisfied images. Conventional images（axial, coronal and sagittal） found 3 cases with LSNRA and nerve reorganization was found in 13 cases, the display rate was 3.09% and 13.40% respectively. There were significant differences between the two groups（P=0.002）. Among the 13 cases of LSNRA, 11 were type Ⅱ（84.62%）, 2 were type Ⅴ（15.38%）. Conclusions： CT nerve colayer display technology can completely and clearly show the distribution of LSNRA and its relationship with adjacent nerve roots, which can be used for clinical diagnosis of LSNRA.