数字化X射线摄影与多层螺旋CT在退行性颈椎间孔狭窄诊断中的价值  

Value of computed radiography and multi-slice spiral CT in the diagnosis of degenerative cervical intervertebral foramen stenosis

作　　者：黄昊[1] 骆伟[1] 刘亚斌[1] 白琛[1] 李育刚[2] HUANG Hao;LUO Wei;LlU Ya-bin(Department o f Radiology ,First A f filiated Hospital of Chengdu Medical College;Spine Surgery,First A f filiated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan)

机构地区：[1]成都医学院第一附属医院放射科,四川成都610500 [2]成都医学院第一附属医院脊柱外科,四川成都610500

出　　处：《中国实验诊断学》2018年第12期2066-2069,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析数字化X射线摄影(DR)与多层螺旋CT(MSCT)在退行性颈椎间孔狭窄诊断中的价值。方法选取2016年5月至2017年7月我院收治的退行性椎间孔狭窄患者206例为研究对象,均行颈椎正、侧、双斜位DR及MSCT检查,采用椎间孔内口、外口、轴位显示及斜位重建,对比两种检查方法下椎间孔狭窄位置、大小及相关参数[C2与C7下终板垂线的夹角(Cobb角)、C2与C7椎体后缘延长线的夹角(Gore角)、颈椎曲率指数(CCI)]。结果 206例患者,在DR颈椎正侧及双斜位片时发现200例可见椎体、小关节骨质增生硬化,MSCT多平面重建、三维重建图像能多方向多方位而又立体直观地显示各椎间孔形态特点;DR检查时,仅观察到340个椎间孔狭窄,其中286个(84.12%)位于C4-5、C5-6,而MSCT检查发现变形狭窄的椎间孔540个,其中501个(92.78%)位于C4-5、C5-6、C6-7,两组比较差异有统计学意义(P<0.05);DR检查下前后径、左右径方向角度、中轴线角度及Cobb角、Gore角均大于MSCT检查(P<0.05),而两种检查方法下CCI比较差异无统计学意义(P>0.05)。结论 DR与MSCT在退行性椎间孔狭窄中有较好诊断价值,尤其是颈椎MSCT可提供各小关节突改变、各椎间孔形态等方面信息,可作为疾病诊断的重要方法。Objective To analyze the value of digitization radiography (DR)and rnulti-slice spiral CT (MSCT)in the diagnosis o{degenerative cervical intervertebral foramen stenosis.Methods 206patients with degenerative interver- tebral foramen stenosis treated in the hospital from May 2016to July 2017were selected as the subjects.The positive, lateral,double oblique DR and MSCT examinations of the cervical spine were performed.The internal opening,external opening and axial position display and oblique reconstruction were used.The location and size of intervertebral foramen and related parameters [the angle between endplate vertical lines under C2and C7(Cobb angle),the angle between ex- tended lines of the posterior margin of the vertebral body (Gore angle)and cervical curvature index (CCI)]were com- pared between the two methods.Results In the 206patients,200cases of vertebral and facet joint hyperostosis and sclerosis were found on the DR positive and double oblique films.Images of MSCT multi-planer reconstruction and three-dimensional reconstruction can directly display the morphological characteristics of the intervertebral foramen.DR examination only showed 340intervertebral foramen stenosis,including 286(84.12%)located in C4-s and C5-6,while MSCT showed 540deformed intervertebral foramen,including 501(92.78%)in C4-s ,Cs-e and C6-7(P<0.05).The an- gles of anteroposterior diameter and transversal diameter,medial axis angle,Cobb angle and Gore angle under DR were all larger than those under MSCT (P<0.05),but there was no statistical difference in CCI between the two methods (P>0.05).Conclusion DR and MSCT are of value in the diagnosis of degenerative intervertebral foramen stenosis. The cervical MSCT can provide the morphological information such as changes of facet joints and morphology of the intervertebral foramen.It can be used as an important method for the diagnosis of the disease.

关 键 词：数字化X射线摄影 多层螺旋CT 退行性颈椎间孔狭窄 诊断价值 

分 类 号：R814[医药卫生—影像医学与核医学]