脊髓造影螺旋CT重建对颈椎病诊治的临床研究

A clinical study of helical CT myelography and reformation on diagnosis and treatment of cervical spondylosis

目的 探讨颈脊髓造影螺旋 CT扫描 (HCTM)多平面重建及三维重建的可行性及对颈椎病诊治的临床应用。方法 将一组手术治疗的颈椎病患者和无颈椎疾患的对照者进行腰穿造影、螺旋 CT扫描、计算机图像重建 ,用于术前病情评价并进行术前计划、制定个体化手术方案。结果 造影剂在 CSF内弥散均匀、显影良好 ,重建图像直观、逼真 ,提供全面颈椎细微骨性解剖和硬膜囊、脊髓、神经根袖等软组织受压信息 ,有助于建立个体化手术方案。各例患者手术进行顺利、无并发症、术后短期随访疗效满意。结论 HCTM及重建提供颈椎病细微解剖信息 ,有较高诊断效能和术前评估、指导术前计划职能 ,提高了颈椎手术的个体化程度、精确性和可控制性。

Objective To discuss the feasibility of 3-D and multi-planer reformation of helical CT myelography, as well as its clinical application on cervical spondylosis.Methods A group of cervical spondylotic patients received surgical intervention and some cases of control group were conducted CT myelography, followed by multiplaner and 3-D image reformation to thoroughly assess and preoperatively plan the disease to setup the optimal individualized surgical procedure.Results Contrast medium was diffused steplessly in subarachnoid space. Reformated images provided detailed multi-angle-viewing anatomic information about surface bony landmark of cervical spine, and compromised dural sac, spinal cord and nerve root sleeves as well., which was rather helpful to setup individualized surgical procedure,so that all of the operations were performed smoothly without any inter- and post- operative complications, and the outcomes of short-term follow-up were encouraging.Conclusion It was demonstrated that HCTM and its reformated imagines providing detailed anatomic information of cervical spondylosis, had proper diagnostic efficiency as well as preoperative assessing and planning function, which improved the level of individualization, precision and security of cervical spine surgery.