多层螺旋CT图像后处理技术对腰椎峡部裂的诊断价值  

Diagnostic value of imaging reconstruction technique by multi-slice spiral CT on spondylolysis

作　　者：谢元忠[1] 孔庆奎[1] 公维云[1] 张立涛[1] 崔群生[1] 

机构地区：[1]山东省泰安市中心医院医学影像中心,271000

出　　处：《中国脊柱脊髓杂志》2008年第7期526-529,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨多层螺旋CT图像后处理技术对腰椎峡部裂的诊断价值。方法:应用多层螺旋CT机对43例腰椎峡部裂患者的腰椎进行扫描,利用多平面重建(MPR)、最大密度投影(MIP)、容积显示技术(VRT)进行多模式图像后处理,多方位观察患者椎弓峡部裂情况。结果:43例患者中共发现83个椎弓峡部裂,双侧32例,其中4例累及两个脊椎的双侧椎弓;单侧11例。腰椎斜矢状位MPR及平行于椎弓的轴位MPR能够诊断全部病例,13例裂隙呈不规则锯齿状,边缘清晰,9例边缘骨质硬化、膨大;12例伴有碎骨块,并见裂隙周围纤维组织增生。正中矢状位MPR发现脊椎向前滑脱22例,其中Ⅰ度滑脱16例,Ⅱ度滑脱5例,Ⅲ度滑脱1例。7例出现假性椎间盘膨出征,硬膜囊向前移行。MIP也能全部显示所有病例的峡部裂,但是对软组织观察不如MPR。高密度VRT仅发现峡部裂23例39处。结论:多层螺旋CT扫描后MPR、MIP及VRT图像后处理技术能够全方位评价腰椎峡部裂的形态变化,为临床提供与峡部裂有关的更多更详细的影像信息,MPR是最有价值的重建方法。Objective：To evaluate the diagnostic value on spondylolysis and spondylolisthesis by using multi- planar reconstructions （MPR）, maximum intensity projection （MIP） and volume rendering technique （VRT） of multi-slice spiral CT（MSCT）.Method：43 cases with spondylolysis were scanned by MSCT.The data was transmitted to 3D workstation and the images were reconstructed with the techniques of MPR,MIP and VRT.Resuit：83 lumbar spondyloschisis in 43 cases,in which 32 cases were bilateral and 11 cases were unilateral, were determined by MPR.Of 32 bilateral cases,4 cases involved bilateral sites of 2 lumbar vertebrae.And oblique sagittal and oblique axial MPR images had displayed small bone fragments and fibro-hyperplasia around the fissure in 12 cases,hyperosteogeny in 9 cases,and jagged edges of fissure in 13 cases.Median sagittal MPR image had revealed the Ⅰ degree slip of upper lumbar body in 16 cases, Ⅱ degree in 5 cases, Ⅲ degree in 1 case.False protrusion of intervertebral disc and dural sac antedisplacement were found in 7 cases. MIP image had displayed all the focus of these cases ,but viewing of soft tissue not as well as MPR. Only 39 sites of lumbar spondyloschisis in 23 cases were found by high density VRT.Condusion：The spiral scanning,MPR,MIP and VRT techniques can display more lesion information of the spondylolysis,these techniques are important in diagnosis of this disease and provide more valid information for clinical doctors.MPR is the most valuable reconstruction technique in diagnosing spondylolysis.

关 键 词：腰椎峡部裂 多层螺旋CT扫描 多平面重建 最大密度投影 容积成像 

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