腰神经根HRCT同层显示重建与腰椎间盘突出和/或膨出整体关系影像学的诊断价值  

Value of multiplanar reconstruction of lumbar nerve roots on the same level by high resolution computed tomography in diagnosis of lumbar disc hernition and/or bulge

作　　者：林井副[1] 梁英魁[1] 张燕群[1] 姜丽[1] 赵书臣[1] 李晓娟[1] 宋志丹[1] 葛合全[1] 王建和[1] 王占宇[1] 佐拥军[1] 郑奎红[1] 

机构地区：[1]海军总医院影像科,北京100037

出　　处：《中华医学杂志》2007年第22期1545-1548,共4页National Medical Journal of China

摘　　要：目的探讨16层螺旋 CT 对腰神经根多平面同层显示重建与腰椎间盘突出和/或膨出(LDHB)整体关系的影像学诊断价值,为临床相关疾病的诊断提供依据。方法共选31例(50个节段)均有典型 LDHB 临床症状及体征的患者,经 CT 扫描多平面重建,利用同层显示技术诊断为LDHB,后经手术及病理证实。使用美国 GE 公司制造的 Light Speed 16层螺旋 CT 扫描,在 ADW4.1工作站上,UNIX 操作系统对腰神经根进行多平面重建,取其同层显示层面分析其与椎间盘整体关系的异常表现。结果在同层显示下不仅清晰可见有无 LDHB,同时可表现整体神经根走行此处多项指标的异常变化,其中主要包括:二者有接触或接触的范围增大(100%)、神经根移位(96%)、形态学变化(94%)、粗细的变化(92%)、走行方向变化(88%)、密度的变化(80%)、硬膜囊与神经根夹角增大(76%)及其周围组织继发性等异常改变。随 LDHB 时间的延长,受压的神经根可表现由增粗到变细。结论 16层螺旋 CT 同层显示重建可十分理想地显示 LDHB 与神经根走行整体下的各种异常关系及大体判断神经根新旧损伤的病理变化。这一技术对 LDHB 的影像学诊断及临床治疗具有极大的应用价值。Objective To explore value of multiplanar reconstruction of lumbar nerve roots on the same level by high resolution computed tomography （HRCT） in diagnosis of lumbar disc hernition and/or bulge （LDHB）. Methods Thirty-one patients with manifestations of typical nerve root compression, such as lumbago and tenderness of percussion pain at the corresponding sites were scanned with 16-slice spiral CT and multiplanar reconstruction of lumbar nerve roots on the same level with the workshop ADW4. 150, and were diagnosed as with LDHB with 50 segments. The diagnoses were confirmed by operation later. Results This technique showed not only the existence of LDHB but also the signs of nerve root compression, including the touch of nerve roots with the LDHB （100%）, translocation of nerve roots （96%）, morphological change （ 94% ） , changes of diameter （ 92% ）, changes of direction （ 88% ） , changes of density （ 80% ） , increase of the angle between the dural sac and nerve root （76%） , etc. Along with the prolonging of time, the nerve roots became thinner in all segments. Conclusion Multiplanar reconstruction of lumbar nerve roots on the same level by high resolution computed tomography is valuable in the diagnosis of lumbar disc hernition and/or bulge.

关 键 词：脊神经根 腰骶部 椎间盘移位 图像处理 计算机辅助 

分 类 号：R681.53[医药卫生—骨科学]