腰椎管狭窄症患者动力位下CT3D椎管容积变化研究  

Study of CT3D Spinal Canal Volume Changes in Patients with Lumbar Spinal Stenosis in the Powered Position

作　　者：施玉森[1] 李茂弘 涂蓉[1] SHI Yu-sen;LI Mao-hong;TU Rong(Department of Radiology,The First Affiliated Hospital of Hainan Medical College,Haikou 570102,Hainan Province,China)

机构地区：[1]海南医学院第一附属医院放射科,海南海口570102

出　　处：《中国CT和MRI杂志》2023年第5期136-138,共3页Chinese Journal of CT and MRI

摘　　要：目的 运用三维CT(CT3D)技术分析腰椎管狭窄症(LSS)患者动力位下椎管容积变化情况。方法 选取2019年2月至2020年12月海南医学院第一附属医院收治的30例LSS患者为研究对象,在仰卧位及动力位下均接受CT容积扫描和3D重建。分析比较不同体位下及各节段椎管硬膜囊总体容积、段腰椎间盘中位硬膜囊横截面积、腰椎体中位硬膜囊横截面积、最狭窄节段硬膜囊径线、最狭窄节段距离等。结果 过屈位下总体容积最高,过伸位下总体容积最低,不同体位下腰椎管硬膜囊总体容积比较,差异有统计学意义(F=14.267,P<0.05)。仰卧位和过屈位下L1/2、L2/3、L3/4、L4/5腰椎管硬膜囊总体容积高于过伸位,过屈位高于仰卧位(P<0.05);同时不同体位下腰椎管硬膜囊总体容积随腰椎节段升高而降低(P<0.05)。过屈位下各节段腰椎间盘中位硬膜囊横截面积高于过伸位(P<0.05)。不同体位下腰椎体中位硬膜囊横截面积随腰椎体中位升高而降低(P<0.05)。仰卧位与过屈位、过伸位下腰椎管硬膜囊最狭窄节段横径、矢状径及腰椎管最狭窄节段骨性椎管前缘至硬膜囊前缘距离、硬膜囊后缘至骨性椎管后缘距离比较无差异(P>0.05)。结论 椎管造影下CT3D可全面精确且立体的测量LSS患者动力位下椎管容积,容积大小依次为过屈位、仰卧位、过伸位,CT3D容积测量优于面积和经线测量。Objective Analysis of spinal canal volume changes in patients with lumbar spinal stenosis(LSS)in the powered position using three-dimensional CT(CT3D)technology.Methods Thirty patients with LSS admitted to the First Affiliated Hospital of Hainan Medical College from February 2019 to December 2020 were selected for the study and underwent CT volumetric scanning and 3D reconstruction in both supine and powered positions.The overall dural sac volume,segmental lumbar disc median dural sac cross-sectional area,lumbar vertebral body median dural sac cross-sectional area,dural sac diameter of the narrowest segment,and distance of the narrowest segment were analyzed and compared in different positions and at each segment.Results The overall volume was highest in the hyperflexion position and lowest in the hyperextension position,and the difference was statistically significant when comparing the overall volume of the lumbar dural sac in different positions(F=14.267,P<0.05).The overall volume of the lumbar dural sac was higher in the supine and hyperflexion positions than in the hyperextension position,and higher in the hyperflexion position than in the supine position(P<0.05);at the same time,the overall volume of the lumbar dural sac decreased with increasing lumbar segmentation in different positions(P<0.05).The cross-sectional area of the median dural sac was higher in all segments of the lumbar disc in hyperflexion than in hyperextension(P<0.05).The crosssectional area of the median dural sac was higher in all segments of the lumbar disc in hyperflexion than in hyperextension(P<0.05).There was no difference in the transverse diameter and sagittal diameter of the most narrowed segment of the lumbar spinal canal in the supine position compared with the most narrowed segment of the lumbar spinal canal in the hyperflexion and hyperextension positions and the distance from the anterior edge of the bony spinal canal to the anterior edge of the dural sac and the distance from the posterior edge of the dural sac to the poste

关 键 词：腰椎管狭窄症 三维CT 动力位 椎管容积 

分 类 号：R445.3[医药卫生—影像医学与核医学]