双排螺旋CT联合X线平片检查诊断在腰椎间盘突出症诊断中的应用价值

Application Value of Dual-Slice CT Plus Plain X-ray on Diagnosis of Lumbar Disc Herniation

目的分析双排螺旋CT联合X线平片用于腰椎间盘突出症的诊断效果和应用价值。方法收集40例腰椎间盘突出症手术患者,行双排螺旋CT、X线平片检查,分析两种检查方法的影像学特征,并以手术病理结果为标准,比较单一检查、联合检查的符合率。结果以手术结果为标准,腰椎间盘突出单一X线平片检查符合率为47.5%;单一双排螺旋CT检查符合率为90%;X线平片联合CT检查符合率为100%。联合检查与单一X线平片检查、单一CT检查比较差异均有统计学意义(P<0.05)。双排螺旋CT腰椎间盘突出症诊断分型符合率为95%,与手术病理结果比较差异无统计学意义(P>0.05)。X线平片提示,腰椎间隙宽度和长度明显异常,腰椎生理弯曲,呈弓状、后翘状态。CT检查提示,椎体边缘可见椎间盘突出,密度稍低于椎间盘,小关节突增生,结节不规则,侧隐窝狭窄,突出块较大时,可见软组织密度影,硬膜囊、神经根表现为变形、移位,甚至消失。结论X线平片、CT检查在腰椎间盘突出症诊断中各具优势,但若单一检查,容易发生误诊、漏诊等不良事件,两者联合诊断,可有效提高诊断符合率,为临床治疗提供可靠的影像学依据,具有重要的研究价值。

Objective To analyze the diagnosis value of dual-slice CT and plain X-ray in lumbar disc herniation.Methods 40 lumbar disc herniation patients treated in our hospital were investigated.Dual-slice CT and plain X-ray were performed.Imaging features were analyzed.According to surgical and pathological results,diagnosis accordance rate of single examination and combined examination was compared.Results Based on surgical and pathological results,diagnosis accordance rate of lumbar disc herniation positions based on combined examination(100%)was significantly higher than that of plain X-ray(47.5%)and dual-slice CT(90%)(P<0.05);diagnosis accordance rate of disease classifications based on dual-slice was 95%;there was no significant difference with surgical and pathological results(P>0.05).X-ray results indicated the abnormal lumbar vertebral space width and length,physiological curve of lumbar vertebra in arciform and warped state.CT results indicated slipped disc in vertebral edge,low density than that of intervertebral disc,proliferated facet joint,irregular nodes,lateral recess stenosis,large masses,soft tissue density image,dural sac,and deformed,displaced or even disappeared nerve root.Conclusion Both of X-ray and CT have its advantages for diagnosis of lumbar disc herniation;however,single examination is prone to have the misdiagnosis and missed diagnosis events.Therefore,combined examination can increase the diagnosis accordance rate and provide reliable imaging basis on clinical treatment.