脊柱病变多层螺旋CT的应用价值

Evaluation of spine diseases with multiple-slice helical CT

目的 :探讨多层螺旋CT对于脊柱病变的诊断价值。方法 :搜集脊柱病变患者 18例 ,其中脊柱骨折 7例 ,颈椎后纵韧带骨化 2例 ,腰椎结核 2例 ,特发性脊柱侧弯 7例。所有患者经多层螺旋CT扫描 ,MIP、MPR/CPR、3D SSD与 4D An gio重建 ,分析不同处理后图像的应用价值。结果 :MRP/CPR应用简捷 ,可矢状、冠状观察骨性病变的部位与程度 ,但对于胸椎骨折或侧弯 ,由于受到肋骨重叠的显示而不适用于评价胸椎骨折 ;3D SSD可观察骨性结构的破坏 ,但缺乏对椎管形态的显示 ,4维重建可清晰评价脊柱骨折与脊柱侧弯的所有相关表现 ,通过调节不同密度阈值可显示出椎管内形态 ,尤其适用观察骨折、侧弯的分类与椎管的状况。结论 :多层螺旋CT可全脊柱扫描 ,其多种后处理技术的应用可全面评价脊柱病变 ,4维重建可清晰评价脊柱病变的所有相关表现 ,而MIP不适用于对脊柱的评价。

Objective:To disscuss the value of multiple slice helical CT for diagnosis of spine diseases.Methods:18 cases with spine diseases,most of them were spine fracture,idiopathic scoliosis etc were studied.All patients were performed multiple slice CT scan and the images were reconstructed by maximal intensity projection (MIP),multiple/curved planner reconstruction (MPR/CPR),three dimension surface shading display (3D SSD) and four dimension angio (4D Angio) technique.The value of the various images for diagnosis was assessed.Results:MRP/CPR technique was easily used for sagittal and coronary,but not good for thoracic spine fracture or scoliosis because of overlapping of the rib;3D SSD could be used only for observing the changes of spine structure,not for displaying the spinal canal;4D angio could clearly show the shape,position and degree of spine fracture and scoliosis through adjusting different density threshold.Conclusion:MSCT can be used for scanning of the whole spine,various reconstruction techniques can evaluate spine diseases comprehensively,especially the 4D angio technique.