基于CT值的腰椎间盘突出症坐标分区法

Coordinates partition of lumbar disc herniation based on CT value

目的 依据腰椎间盘突出症（LDH）在CT或MRI的图像,提出一种基于CT值的更为简单精确地描述突出物大小和位置的坐标分区方法,为腰椎间盘突出诊断及手术治疗的选择提供参考.方法 由经验丰富的临床医师和影像学专家共同制定该系统.分析腰椎间盘突出症患者的CT和MR资料,根据LDH的程度按坐标分区给予分类.按腰椎间盘的解剖结构特征和临床病理特点按X、Y、Z坐标轴进行定位.结果 在该系统中,将突出物在椎管中所处的位置从X轴（水平面）、Y轴（矢状面）、Z轴（冠状面）以坐标轴分区方式划分,其中,X、Y坐标轴划分为8区（-4～-4）,Z轴划分为4区（1～4）;突出物大小以相对应位置区的绝对值之和描述,并按其数值大小表示突出的程度,数值越大表示突出程度越严重.结论 基于CT值的坐标轴分区法可以很好地反映腰椎间盘突出的病理类型、突出的精确位置及其严重程度,从而可为LDH的诊断、手术方法以及手术时机的选择提供重要的参考依据.

Objective According to the CT or MRI images of lumbar disc herniation （LDH）,a simple and accurate coordinate partitioning method for describing the size and location of protrusions based on CT value was proposed.This method can provide a reference for the diagnosis and surgical treatment of LDH.Method The system was developed by experienced clinicians and imaging experts.In this system,CT and MR data of patients with LDH was analyzed,and classified by coordinate partition according to the degree of LDH.According to the lumbar disc anatomical and clinical features,the protrusions were located in X axis,Y axis,and Z axis.Results In this system,the position of the protrusions in the spinal canal was respectively partitioned from X axis （horizontal plane）,Y axis （sagittal plane） and Z axis （coronal plane）,where the X and Y axes were divided into 8 zones （-4 to 4） and the Z axis was divided into 4 zones （1 to 4）.The size,i.e.the degree of protrusions,was described by the sum of the absolute values of the corresponding position zones.The greater the value,the more serious of the protrusion is.Conclusion The method of coordinate partitioning based on CT value can well reflect the pathological types,precise position and degree of LDH,and thus provide references for the diagnosis and the selection of surgical methods and surgical occasion of LDH.