螺旋CT多层面容积重建对下腰椎侧隐窝狭窄症的评价(附78例分析)  

Evaluation of lateral recess stenosis by helical CT multi-plane volume reconstruction(an analysis of 78 cases)

作　　者：孙宪昶[1] 刘庆伟[2] 高建华[1] 赵素红[3] 张如意[1] 

机构地区：[1]武警总医院CT科,北京100039 [2]山东省立医院PET-CT诊疗中心,山东济南250021 [3]山东大学第二医院放射科,山东济南250033

出　　处：《医学影像学杂志》2008年第1期60-63,共4页Journal of Medical Imaging

摘　　要：目的:通过螺旋CT多层面容积重建,探讨侧隐窝狭窄与神经根受压之间的关系。方法:选取CT检查诊断和临床证实的侧隐窝狭窄78例患者资料,根据临床特征分成2组,即狭窄组(无神经根受压21例)和狭窄症组(有神经根受压57例)。所获数据行χ2检验。结果:侧隐窝狭窄发生率在各椎体分布不等,L5和S1狭窄出现率较高,94侧(79.66%),二者之间无显著性差异(P>0.05)。狭窄组主要分布在L4(18侧),狭窄症组主要在L5和S1(86侧)。L4、L5、S1不同椎体之间出现侧隐窝狭窄时,神经根受压出现率不同,L4明显较L5和S1神经根受压出现率小,L4与L5或L4与S1之间有显著差异(P<0.01)。而L5与S1的出现率相近,不存在显著性差异(P>0.05)。椎间盘膨出/突出,上关节突增生内聚是两个最常见的因素。结论:螺旋CT多层面容积重建可准确评价侧隐窝狭窄与神经根受压之间的关系。对于侧隐窝狭窄的分析,要注意对可能引起侧隐窝狭窄的发育、退变、骨性和软组织等因素进行综合的评价。Objective： To study the relationship between the laterul recess stenosis and the compression of nerve rotes using helical CT multi-plane volume reconstruction.Methods： According to the clinical characteristics, 78 pationts were divided into two groups： the group one （21 eases） with the lateral recess stenosis but without nerve roots compressed and, the group two （57 eases） with the lateral recess stenasis and nerve roots compressed. x^2-test was used to test the results.Results：The distribution of incidence of narrow lateral recesses was not consistent with each centnan： the narrow rate was higher in L 5 and S1 （94 sides 79.66% ） than in L 4, but no significant difference （ P 〉 0.05）. Narrow lateral recesses occurred mainly at L 4 （ 18 sides） and lateral recess stenosis in L 5 and S1 （86 sides）. The incidence rotes of nerve root compression were different between I4/L5/S1. The compression rate at L4 was significant lower than the other two. And there were significant difference between L4/L5 and L4/S1（ P 〈 0.01）. However, the incidence rate in Ls and S1 were equal （ P 〉 0.05）. The two frequent factors were intervetebral disc hertfiation/disc bulge and hyperostosis ostcesclerosis of the upper zygapophysis. Condusion： The lateral recess stenosis and the compression of nerve roots can be showed clearly by using helical CT multiplane volume reconstruction. As far as the analysis of narrow lateral recesses cencemed, we should pay more attention to all factors that could lead to the lateral recess narrow, such as developmental factors, degenerative factors, bone factors, and soft tissue factors.

关 键 词：腰椎侧隐窝 体层摄影术 X线计算机 多层面容积重建 

分 类 号：R681.5[医药卫生—骨科学] R814.42[医药卫生—外科学]