脊髓造影CT扫描对腰椎间盘突出继发脊髓马尾形态变化的诊断价值

Diagnostic value of CT myelography in morphological changes of cauda equina secondary to lumbar disc herniation

目的探讨脊髓造影CT扫描对椎间盘突出继发近端脊髓或马尾结构迂曲变形与椎管内肿瘤鉴别诊断的作用。方法回顾性分析海南医学院第一附属医院2016年8月至2019年1月收治的12例椎间盘突出继发近端脊髓或马尾结构迂曲变形患者的临床影像资料,根据患者术前椎管造影CT扫描影像学资料,分析脊髓和神经根与造影剂的相互关系,明确病变性质。结果12例患者术前经脊髓造影CT扫描发现,继发病变的脊髓组织内可见造影剂充盈;术前MRI疑是脊髓占位病变部位,术后复查MRI脊髓占位影像学恢复正常,确定病变组织为椎间盘突出继发近端脊髓或者马尾神经组织迂曲变形。结论根据脊髓造影CT扫描的影像学特征可有效诊断椎间盘突出继发近端脊髓或马尾结构迂曲病变。

Objective To explore the role of CT myelography in differential diagnosis of proximal spinal cord or cauda equina tortuosity secondary to disc herniation and intraspinal tumors.Methods The imaging data of 12 patients with proximal spinal cord or cauda equina tortuosity secondary to disc herniation in the First Affiliated Hospital of Hainan Medical University from August 2016 to January 2019 were collected.CT myelography data was used to analyze the relationship between spinal cord,nerve root,and contrast medium in order to clarify the nature of lesions.Results Preoperative CT myelography of 12 patients showed that the contrast medium was filled in the spinal cord with secondary lesion.Before operation,MRI was suspected to be the lesion site of spinal cord,but postoperative reexamination of MRI spinal cord space-occupying images returned to normal.Therefore,we speculated that the pathological tissue was confirmed as proximal spinal cord or cauda equina nerve secondary to disc herniation.Conclusion The imaging features of CT myelography are effective measures for diagnosis of proximal spinal cord or cauda equina tortuosity secondary to disc herniation.