腰椎退行性不稳定的X线、CT、MRI特征及诊断  

Diagnosis and image characters of degenerative instability of lumbar spine by X-ray,CT and MRI

作　　者：刘郑生[1] 曹勇[1] 侯克东[1] 王岩[1] 朱守荣[1] 肖嵩华[1] 刘保卫[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《军医进修学院学报》2007年第4期246-248,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的:研究腰椎退行性不稳定的X线、CT、MRI表现及其诊断价值。方法:回顾性分析154例临床确诊并经手术证实的退行性腰椎不稳定患者的X线、CT和MRI的特点。退行性腰椎不稳定的临床参考标准以过伸、过屈的侧位X片的典型特征作为主要的诊断依据:椎体滑移超过4mm,或椎间隙角度相差≥15°认为有意义。前后位、侧位及CT、MRI表现作为辅助诊断依据。结果:依据本研究的诊断参考标准,前后位片出现典型变化的105例,占67%,侧位片有特征性改变的111例,占72%,动力位(过伸过屈位)片呈特征性改变的146例,占95%,双斜位片出现特征改变的46例,占30%。CT和MRI检查的患者影像学均呈现不同程度的腰椎退行性变。结论:X线、CT、MRI是诊断腰椎退行性不稳定的重要方法,其特征性改变是确诊本病的主要依据,腰椎过伸、过屈位X线改变是最重要的诊断依据。Objective： To investigate image characters and diagnostic value of X-ray, CT and MRI films on lumbar degenerative instability. Methods： The image characters of X-ray film,CT and MRI in 154 eases with lumbar degenerative instability were analyzed retrospectively. All of eases with lumbar degenerative instability were confirmed by operation. The diagnosis referenee of lumbar degenerative instability primary based on lateral position （LP） films of lumbar hyperextension and hyperflexion position. When lumbar vertebral anterior slipped over 4 mm or segmental angulation exceeded 15 on lumbar sagittal translation were considered significance. The lumbar degenerative instability diagnosis standard secondly based on image characters of anterior-posterior （AP） position, LP, CT and MRI films. Results：According diagnosis reference, typical changing showed in 105 eases （67%） on AP position films, 111 eases （72%） on LP films, 146 eases （95%） on dynamical position films and 46 eases （30%） on bi-oblique position films. The eases with CT and MRI examination were found diversity lumbar degenerative changing on films. Conclusion： The diagnosis of lumbar degenerative instability chiefly bases on the hyperflexion and hyperextension films. The typical changes of X-ray, CT and MRI were extremely important for diagnosis of lumbar degenerative instability.

关 键 词：腰椎 X线 CT 磁共振成像 

分 类 号：R684[医药卫生—骨科学]