腰椎峡部裂三种CT扫描方法诊断价值比较

目的 对比分析三种CT扫描方法对椎弓峡部裂的诊断价值,探讨避免漏诊的方法.方法 回顾分析112例椎弓峡部裂病例,36例采用平行于椎间隙扫描;55例先常规扫描椎间盘,再采用椎弓反角度扫描病变椎间隙;21例行L3～S1螺旋CT扫描再作多平面重建(MPR)或最大密度投影(MIP).结果 平行于椎间隙扫描17%腰椎峡部裂漏诊或显示欠佳,但对继发椎管狭窄及硬膜囊、神经根的受压情况显示良好.椎弓反角度扫描清楚显示全部腰椎峡部裂,但对椎管和椎间盘情况显示欠佳.螺旋扫描结合三维后处理清楚显示全部腰椎峡部裂,对椎管、椎间盘及椎间孔的情况亦显示良好.结论 螺旋CT扫描结合三维后处理可多方位、全面、直观地显示腰椎峡部裂及其所引起的继发改变,是避免漏诊的最好方法.

A comparative study in the diagnosis of lumbar spondyloschisis with three kinds of CT techniques

Objective To compare the diagnostic value of three kinds of CT techniques in lumbar spondyloschisis (SS).Methods One hundred and twelve cases of SS were analyzed. CT scan parallel to intervertebral disc was performed in 36 cases, Reverse gantry CT scan was performed in 55 cases, Spiral CT with MPR or MIP was performed in 21 cases.Results 17% cases could not be diagnosed in CT scan parallel to disc. Reverse gantry CT scan could completely display the signs of SS, but could not display the status of vertebral canal and disc. Spiral CT with MPR or MIP could completely display the signs of SS, while could completely display the status of vertebral canal and intervertebral disc, foramen.Conclusion Spiral CT with MPR or MIP provides valuable diagnostic and anatomic information, thus, it is the best technique in the diagnosis of lumbar spondyloschisis.