SPECT/CT对椎间盘源性腰痛的诊断价值  

Value of SPECT/CT in the diagnosis of discogenic low back pain

作　　者：陈海龙[1] 郑九琴[1] 马俊杰[1] 王军辉[1] 张红星[1] 崔泽升[1] 

机构地区：[1]河南省洛阳正骨医院/河南省骨科医院脊柱外科中心,河南洛阳471002

出　　处：《中国骨与关节外科》2017年第3期191-194,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:椎间盘源性腰痛的诊断一直存在争议,目前的影像学诊断主要为MRI及椎间盘造影,但二者均缺乏一定的敏感性和特异性。目的:探讨SPECT/CT显像对椎间盘源性腰痛的诊断价值。方法:回顾性分析2012年6月至2016年3月收治的30例椎间盘源性腰痛患者的SPECT/CT资料,确定引起腰痛的责任间隙。结果:30例患者SPECT/CT图像显示,L4-5 9例,L5-S1 16例,L4-5和L5-S1双间隙5例;其中,单纯椎间隙放射性浓聚者12例,椎间隙及对应小关节均有放射性浓聚者18例。30例均行责任间隙椎间植骨融合内固定术,术后经6~24个月随访证实,腰部疼痛缓解,功能恢复良好。结论:SPECT/CT显像对椎间盘源性腰痛的诊断及准确定位有良好的应用价值,可提高临床医师对该病的认识和重视,以期对临床工作有所帮助。Background： The diagnosis of discogenic low back pain has been controversial. At present, imaging diagnosis mainly depends on MRI and discography. But both of them are lack of sensitivity and specificity to some extent. Objective：To investigate the value of SPECT/CT imaging in the diagnosis of discogenic low back pain. Methods： We retrospectively analyzed SPECT/CT images from 30 patients with discogenic low back pain hospitalized from June 2012 to March 2016,and determined the involved segments. Results： The results showed that L4-5 was involved in 9 patients, L5-S1 in 16 patients, and L4-5 combined with L5-S1 in 5 patients; there were 12 patients with injury of intervertebral space and 18 patients with injuries of intervertebral space and facet joints. All patients underwent fusion and internal fixation. The pain ameliorated and function recovery was good after 6 to 24 months follow-up. Conclusions： SPECT/CT imaging plays an important role in the diagnosis of discogenic low back pain and accurate positioning of involved segments.

关 键 词：椎间盘 腰痛 体层摄影术 发射型计算机 体层摄影术 X线计算机 

分 类 号：R681.53[医药卫生—骨科学] R817.4[医药卫生—外科学]