腰椎小关节病的CT检查和表现  

CT scan and appearances of the lumbar facet diseases

作　　者：张仲伟[1] 童国海[1] 谭令[1] 陆勇[1] 江浩[1] 何国祥[1] 

机构地区：[1]上海第二医科大学附属瑞金医院放射科,200025

出　　处：《上海医学影像》2000年第1期33-35,共3页Shanghai Medical Imaging

摘　　要：目的 对腰椎小关节病CT表现作出归纳,提高对此病作为腰腿痛的重要病因的认识。方法 连续200例腰腿痛患者,主要作了腰椎L_(4-5)和L_5-S_1的小关节CT平扫,并运用骨窗和软组织窗对图像进行分析和测量。结果 有135例(占67.5％)患者表现为不同节段的腰椎小关节病,CT表现为:骨赘形成;小关节突增生肥大;关节间隙变窄;关节真空现象以及关节囊的钙化等。腰椎小关节病常伴有其它腰椎疾病。讨论 腰椎小关节病是引起腰腿痛的重要病因,常合并腰椎间盘突出症。由于以往捡查技术的局限以及过分强调了腰突症的作用,造成对此病的认识不足,CT具有快速、简单、准确、无创伤性等优点,是检查小关节病首选的影像学方法,对此病的诊断和治疗均有重要指导意义。作者还对椎小关节的解剖,椎小关节病的发病机理以及此病与推间盘病变的关系作了一定的探讨。Purpose To generalize the CT appearances of lumbar facet diseases, and to appreciate the lumbar facet disease which is an important cause of low back pain and sciatica. Methods 200 cases with low back pain and sciatica underwent CT examinations for the facet joints from L4-5 to L5 -S1 . The images were analysed and displayed with both bone window and soft tissue window. Results Abnormal facet joints at the different levels were found in 135 cases (67.5%). Abnormalities demonstrated in CT include: osteophyte formation, hypertrophy of articular processes, joint space narrowing, vacuum joint phenomenon and periarticular calcification. Lumbar facet diseases often occursed in company with other lumbar disorders. Conclusion Lumbar facet disease is one of the important causes of low back pain and sciatica, and usually in company with lumbar disc herniation. It has been ignored because of the limitation of examination technique used before and overemphasis of disc herniation. As being rapid, simple, accurate and noninvasive, CT is the best imaging method of lumbar facet joints examination. The anatomy of facet joint, pathogenesis of lumbar facet diseases and the relationship between lumbar facet diseases and disc herniation are also discussed in the article.

关 键 词：腰椎 小关节病 诊断 CT 

分 类 号：R684.04[医药卫生—骨科学]