【摘要】 目的 探讨螺旋CT三维重建在腰椎峡部裂诊断中的应用价值。方法 腰椎峡部裂病人12例,采用螺旋CT三维重建分析椎体滑脱、峡部裂、骨痂、骨赘和纤维组织增生在最大密度投影(MIP)、表面重建(SSD)、容积再现(VR)及多平面重建(MPR)的表现。结果 MIP、SSD和VR对显示椎体滑脱及峡部裂较好,不能显示骨痂、骨赘和纤维组织增生; MPR显示椎体滑脱、峡部裂、骨痂及骨赘形成和纤维组织增生均较好。结论 螺旋CT三维重建对显示腰椎峡部裂及其相关改变效果良好,对临床制定手术方案具有重要的指导意义。
【关键词】 腰椎峡部裂;体层摄影术,X线计算机;图像处理,计算机辅助
THE VALUE OF 3D RECONSTRUCTION VIA SPIRAL CT IN THE DIAGNOSIS OF LUMBAR SPONDYLOSCHISIS WANG GUANXI, GAO CHUANPING, XIE GUIHUA, et al (Department of Radiology, The Affiliated Songshan Hospital of Qingdao University Medical College, Qingdao 266003, China); [ABSTRACT] Objective To assess the value of 3D reconstruction via spiral CT in the diagnosis of lumbar spondyloschisis (LS). Methods The manifestations of vertebral olisthy, spondyloschisis, osteophyma, bony callus and fibroplasia in maximum intensity projection (MIP), surface shade display (SSD), volume rendering (VR), and multiplanar reformation (MPR) were analyzed with 3D reconstruction via spiral CT in 12 patients with LS. Results Vertebral olisthy and LS were welldisplayed in MIP, SSD, and VR, while osteophyma, bony callus and fibroplasia were not demonstrated. Vertebral olisthy, spondyloschisis, osteophyma and fibroplasia were all welldemonstrated in MPR. Conclusion 3D reconstruction via spiral CT plays an important role in detecting LS and its related changes, which possesses a great guidance in making a operative proposal.
[KEY WORDS] Lumber spondyloschisis; Tomography, Xray computed; Image processing, computerassisted
腰椎峡部裂又称为腰椎椎弓崩裂,是椎弓上下关节突之间的狭细部分骨质缺损。由峡部裂及其导致的脊椎滑脱是临床腰腿痛常见的原因之一,病变以第5腰椎峡部最常见,可发生于单侧或双侧。无腰椎滑脱的腰椎峡部裂,常规椎间盘CT扫描有时不能显示峡部裂,可导致漏诊。本研究对12例椎弓峡部裂病人进行了螺旋CT三维重建,探讨螺旋CT三维重建在腰椎峡部裂诊断中的应用价值。
1 资料和方法
1.1 一般资料
椎弓峡部裂病人12例,男7例,女5例;年龄17~65岁,平均41.2岁。以腰痛、下肢麻木或腰部外伤等原因来院就诊。病史1月~15年。
1.2 扫描方法及后处理
采用GE Light Speed 16层螺旋CT机扫描参数:电压为120~180 kV,电流为150 mA,准直为4.0 mm&time
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