CT硬膜外造影对腰椎管狭窄症的诊断价值

Computed tomography epidurography for imaging diagnosis of lumbar spinal stenosis

目的:探讨硬膜外造影后CT(CT-E)对腰椎管狭窄症的诊断价值及影像特征。方法:对27例腰椎管狭窄症患者行腰椎X线平片及单纯CT检查后再行CT-E检查。CT-E扫描椎体下1/3、椎间隙、椎体上缘平面,结合单纯CT及手术所见行对比分析。结果:CT-E诊断中央管狭窄3例,中央管伴侧隐窝狭窄2例,侧隐窝狭窄16例,神经根管狭窄4例,椎间孔狭窄2例。与手术所见吻合25例,诊断准确率达93%;单纯CT与手术所见吻合23例,诊断准确率为85%。结论:CT-E对腰椎管狭窄症更具有定性、定位诊断作用,可为有限化手术提供依据。

Objective:To exvaluate the clinical value of CT-E(computed tomography epidurography)for imaging diagnosis of lumbar spinal stenosis and analyse the image features.Method:27cases of lumbar spinal stenosis were respectively assessed with CT-E and conventional CT for preoperative diagnosis.The preoperative imaging diagnosis were compared with operation respectively.Result:3cases of central stenosis,2cases of central stenosis associated lateral stenosis,16cases of lateral stenosis,4cases of nerve root canal stenosis and2cases of foramen stenosis were revealed by CT-E with a accurate rate of93%compared with operation.3cases of central stenosis,3cases of central stenosis associated lateral stenosis,21cases of lateral stenosis were revealed by CT with a accurate rate of85%compared with operation.Conclusion:CT-E is helpful in diagnosing and locating for lumbar spinal stenosis and particularly is complementary when CT or myelography does not reveal the source of the patient's symptom.