多层螺旋CT多平面重建与容积再现技术在第5腰椎横突肥大综合征中的应用价值  

Application value of multislice spiral CT MPR and VR in syndrome for hypertrophy of transverse process of the fifth lumbar vertebra

作　　者：王磊[1] 王琨[1] 裴昌军[1] 蔡维波[1] 

机构地区：[1]江苏省泗洪县人民医院CT室,223900

出　　处：《实用医学影像杂志》2016年第6期471-474,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨多层螺旋CT(MSCT)多平面重建(MPR)及容积再现(VR)后处理技术在第5腰椎横突肥大(HTPL5V)综合征中的诊断价值。方法 25例临床诊断为HTPL5V综合征患者,均行MSCT容积扫描,在工作站上进行MPR及VR重建,全面观察其形态特征、与邻近骶骨关系及第5腰神经受压情况。结果 25例中,共36侧横突过度肥大,表现为宽度、长度及厚度增大,以宽度增大为主;共发现HTPL5V有4种类型:Ⅰ型(单纯型)、Ⅱ型(假关节型)、Ⅲ型(融合型)、Ⅳ型(混合型),其中Ⅰ型2例,Ⅱ型15例,Ⅲ型5例,Ⅳ型3例;共观察到30侧假性孔道形成,有7侧Ⅱ型肥大所形成的假性孔道外侧壁的内缘增生致孔道狭窄,第5腰神经受压,1侧Ⅲ型肥大所形成的假性孔道整体狭小致第5腰神经受卡压。结论 MSCT多平面重建与容积再现技术在诊断HTPL5V综合征中具有重要价值。Objective To investigate the diagnostic value of multi-slice spiral CT（MSCT） multi planar reconstruction（MPR） and volume rendering（VR） technique in the treatment of fifth lumbar transverse process hypertrophy（HTPL5V） syndrome. Methods Twenty-five patients with a clinical diagnosis of HTPL5 V syndrome in patients underwent MSCT volume scan, MPR and VR reconstruction in workstation was done, comprehensively observe the mor-phological characteristics, and the relationship between the sacrum and 5 adjacent lumbar nerve compression was an-alyzed. Results In 25 cases, a total of 36 lateral transverse hypertrophy, width, length and thickness were increased with increasing the width of the main; There were four types of HTPL5V： type Ⅰ（simple type）, type Ⅱ（pseudarthrosis type）, type Ⅲ（fusion type）, type Ⅳ（mixed type）, among all cases, two cases in type Ⅰ, fifteen cases type Ⅱ, five cases type Ⅲ, three cases Ⅳ; Thirty sides false foramina formation were observed, there were seven sides inner edge hyperplasia of paries lateralis of false foramina formed by type Ⅱ hypertrophy resulting in aretation and compression on L5 nerve, one side small false foramina as a whole formed by type Ⅲ hyperplasia leading to L5 lumbar nerve undergoing compression. Conclusion Technology of MSCT with MPR and VR was of great value in diagnosing syndrome for HTPL5 V.

关 键 词：第五腰椎横突综合症 腰痛 体层摄影术 X线计算机 多平面重建 容积再现 

分 类 号：R681.5[医药卫生—骨科学]