腰椎小关节退变的CT征象分析  

CT study of degenerative lumbar facet joint

作　　者：金发智 Jin Fazhi(Department of Radiolog;Donggang Hospitalogy First Hospital of Lanzhou University,Gansu 730000,China)

机构地区：[1]兰州大学第一医院东岗院区放射科,730000

出　　处：《实用医学影像杂志》2018年第4期326-328,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨腰椎小关节退变的CT征象及其临床意义。方法回顾性分析54例腰痛患者的腰椎CT资料。男15例,女39例;年龄45~75岁。采用CT扫描观察L3/4~L5/S1节段椎间盘退变的CT征象及相对应椎小关节面、关节间隙、骨质变化。结果腰椎小关节退变累及三节椎小关节24例,两节18例,单节12例;同时伴有椎间盘膨出累及三节18例、两节24例、一节6例,椎间盘突出6例,合并椎体滑脱17例。腰椎小关节退变CT征象为:关节突增生肥大,椎小关节呈"握球"状态,椎小关节间隙狭窄或消失,部分关节间隙出现"真空征",关节面骨硬化和关节面下小囊状改变;腰椎体滑脱合并椎小关节退变CT征象为椎小关节呈半脱位状态,关节面碎裂,关节间隙增宽。结论腰椎小关节病变与椎间盘退变具有相关性,多层螺旋CT对腰椎小关节退变程度的评估有临床指导意义。Objective To investigate CT features of degenerative lumbar facet joint and its clinical significance. Methods The CT data of lumbar spine from 54 patients with low back pain were retrospectively analyzed.There were 15 males and 39 females aging 45 to 75 years old. CT scans were used to observe the CT signs of lumbar3/4 ~ lumbar 5/sacral 1-segment disc degeneration and the corresponding vertebral articular surface, joint space and bone changes. Results The degeneration of lumbar facet joint involved 24 cases of three vertebral facet joint, 18 sec-tions in two sections and 12 cases in single section. There were 18 cases in three sections, 24 cases in two sections, 6 cases in one section and 6 cases in disc herniation, 17 cases combined vertebral body slipping. Degeneration of lum-bar facet joint CT signs： hypertrophy of joint sudden hypertrophy, vertebral facet joint was observed as ＂holding the ball＂ state, the joint space narrowed or disappeared, part of the joint gap observed as ＂vacuum sign＂, articular surface sclerosis and small joint surface cystic changes were found; CT signs of lumbar spondylolisthesis with degeneration of vertebral facet joint were shoued as subluxation of the facet joint status, articular surface fragmentation, widened joint space. Conclusion The degeneration of lumbar facet joint is related to the degeneration of intervertebral disc. The evaluation of degeneration of lumbar facet joint by multi-slice spiral CT is of clinical significance.

关 键 词：腰椎小关节 骨关节病 体层摄影术 X线计算机 

分 类 号：R684[医药卫生—骨科学] R816.8[医药卫生—外科学]