第5腰椎横突肥大综合征高分辨CT重建及其诊断价值  

High-resolution CT Reconstruction and Diagnosis in Syndrome for Hypertrophy of Transverse Process of the Fifth Lumbar Vertebra

作　　者：彭建鸿[1,2] 杨铁[3] 路桂军[4] 肖越[3] 林井副[2] 

机构地区：[1]南方医科大学第三临床医学院,广东广州510630 [2]海军总医院影像科,北京100048 [3]解放军总医院放射诊断科,北京100853 [4]解放军总医院疼痛科,北京100853

出　　处：《中国医学影像学杂志》2014年第10期777-780,共4页Chinese Journal of Medical Imaging

基　　金：海军后勤部科研计划项目(07-3306)

摘　　要：目的探讨高分辨CT重建同层显示第5腰椎横突肥大(HTPL5V)综合征中第5腰神经异常的诊断价值。为临床诊断及治疗提供依据。资料与方法 22例临床诊断为HTPL5V综合征的患者及20例第5腰神经正常者,采用GE LightSpeed 16层螺旋CT机(36例)和Philips iCT 256层螺旋CT机(6例)进行常规扫描,在自身配备的工作站上重建并观察正常者与HTPL5V综合征患者的横突及第5腰神经。结果 22例HTPL5V患者中,26侧肥大横突与骶骨翼形成假关节,2侧与骶骨翼接触;28侧第5腰神经走行在假性孔道内,其中6例双侧第5腰神经受压,16例单侧受压。21例27侧(96.4%)孔道壁骨质增生压迫第5腰神经,1例1侧(3.6%)孔道相对狭窄压迫第5腰神经。25侧(89.3%)受压的第5腰神经呈弧形,3侧(10.7%)呈直线形。7例9侧(32.1%)同时伴有椎间盘膨出和(或)突出压迫。结论高分辨CT重建同层显示技术可以清晰地显示HTPL5V综合征中第5腰神经是否受压、变形等,为临床诊断及治疗HTPL5V综合征提供依据。Purpose To investigate the diagnostic value of high-resolution CT reconstruction techniques on the same slice in hypertrophy of transverse process of the fifth lumbar vertebra（HTPL5V）, and to provide a basis for clinical diagnosis and treatment. Materials and Methods Twenty-two cases of clinically diagnosed HTPL5 V and 20 normal adults were examined with GE LightSpeed 16-slice spiral CT（36 cases） and Philips iCT 256-slice（6 cases）. L5 transverse process and the fifth lumber nerve were reconstructed and observed on the workstations. Results In 22 cases of HTPL5 V, there were 26 pseudarthrosis formation and 2 sides with L5 transverse process touching the sacral ala. In 28 sides the fifth lumber nerve traveled through false foramina of the HTPL5 V including 6 cases of bilateral compression and 16 cases of unilateral compression. In 21 cases, the nerve was compressed by hyperosteogeny on 27 sides（96.4%） and 1 side due to stenosis（3.6%）. On 25 sides（89.3%） the compressed nerves were curved in shaper. There was bulging and/or herniated lumbar disc on 9 sides in 7 cases（32.1%）. Conclusion High-resolution CT reconstruction techniques can demonstrate the fifth lumbar nerve of HTPL5 V and provide evidence for clinical diagnosis and treatment.

关 键 词：第5腰椎横突肥大综合征 腰腿痛 体层摄影术 螺旋计算机 

分 类 号：R681.55[医药卫生—骨科学] R445.3[医药卫生—外科学]