螺旋CT多平面重建对极外侧型腰椎间盘突出症的诊断  

Diagnosis of extreme lateral lumbar disc herniation with spiral CT multiplanar reformation

作　　者：胡小新[1] 陈时洪[1] 孙兰[1] 

机构地区：[1]广东省第二中医院放射科,广州510095

出　　处：《中华放射学杂志》2003年第7期629-632,共4页Chinese Journal of Radiology

摘　　要：目的　探讨极外侧型腰椎间盘突出症 (ELLDH)在螺旋CT多平面重建 (MPR)的特征表现 ,提高对该病的诊断率。方法　对 2 5例ELLDH进行常规CT扫描 +薄层螺旋扫描和冠状面、矢状面的MPR ;2 5例中男 18例 ,女 7例 ,均经手术证实。结果　 2 5例ELLDHMPR显示椎间盘突出部位及压迫同位节段脊神经根情况与手术所见基本相符 ,其中椎间孔内突出 15例 ,椎间孔外侧突出 4例 ,椎间孔内外突出 3例 ,椎间孔内并同节段椎管内后外侧突出 3例。其MPR特征为突入椎间孔内和椎间孔外的软组织块影 ,压迫同位节段脊神经根 ,形态多呈丘状、圆形或三角形。 2 5例ELLDH中有 7例常规CT扫描未发现ELLDH ,病人再行MPR均发现ELLDH ;8例常规CT扫描显示ELLDH可疑 ,通过MPR得到明确诊断 ;10例常规CT扫描虽发现ELLDH ,但不能清楚显示神经根受压情况 ;2 5例ELLDH通过MPR均直接显示了神经根受压情况。结论　MPR在ELLDH的诊断中具有重要价值 ,能准确地提供椎间盘突出的部位、形态、大小以及与神经根的关系等解剖学信息 ,有助于临床医师选择手术方式。Objective To investigate the characteristics of extreme lateral lumbar disc herniation (ELLDH) with spiral CT multiplanar reformation (MPR), and to determine the effectiveness of MPR in the diagnosis of ELLDH. Method Twenty-five cases with ELLDH underwent conventional CT scans, thin slice spiral scan, and MPR on coronal and sagittal plane. Results Operative findings basically matched the MPR results in 25 ELLDH patients concerning the disc herniation position and compression of the nerve roots. The herniation involved the intervertebral foramina in 15 cases, external intervertebral foramina in 4, both intervertebral and external intervertebral foramina in 3, and intervertebral foramina and vertebral tubes of parity plane in 3. They were demonstrated on MPR as shapes of hillock, circular or trigonal soft-tissue density mass in intervertebral foramen, or outside and tread on the nerve root of parity plane. Among these 25 ELLDH cases, ELLDH was not found by conventional CT scans in 7 cases, but was found by MPR. ELLDH was suspected by conventional CT in 8, and was confirmed to be ELLDH by MPR. ELLDH was revealed by conventional CT scans in 10, but without indications of nerve root compression status, while MPR clearly indicated nerve root compression status. Conclusion MPR has important value in the diagnosis of ELLDH. It can properly identify the ELLDH site, shape, size, and its relation to nerve roots. It is very helpful for the surgeons in the selection of operation method.

关 键 词：极外侧型腰椎间盘突出症 螺旋CT多平面重建 诊断价值 解剖学 

分 类 号：R816.8[医药卫生—放射医学]