CT在腰椎椎弓峡部不连中的临床应用.DOCVIP

临床医学论文-CT在腰椎椎弓峡部不连中的临床应用 【摘要】? 目的? 探讨CT在腰椎椎弓峡部不连诊断中的临床价值及提高检出率。方法? 用PICKER-1200 CT机检查，总结56例不伴有明显椎体移位的腰椎椎弓峡部不连患者CT征象，并结合定位像进行分析。结果? 腰椎椎弓峡部不连的特征性表现是椎弓骨性环连续性中断。在CT诊断明确的腰椎椎弓峡部不连的病例中，37例在侧位定位像上，同一腰椎上、下小关节突间出现骨质不连续，19例局部骨质结构紊乱、增粗。结论? 常规CT检查腰椎间盘病变时，在不伴有明显椎体移位的情况下，如果定位像上腰椎椎弓部上、下小关节突间出现骨质不连续，类似椎体“断尾征”，以及局部骨质结构紊乱、增粗时增加扫描范围，对腰椎弓峡部不连的早期诊断有一定意义。??? ??? 【关键词】? 腰椎椎弓峡部不连? 腰椎定位像? 计算机断层摄影???????? 【Abstract】? Objective? To evaluate diagnostic value of CT in spondylolysis of lumbar spine and to improve its positive ratio.Methods? 56 cases of spondylolysis of lumbar spine which did not accompany overt dislocation were performed with PICKER-1200 CT.The authors summarized their CT characteristics and analysed them combining to the topography.Results? The characteristic performance that the spondylolysis of lumbar spine was the bone wreath consecution to break off.In CT diagnosis that the explicit spondylolysis of lumbar spine，37 examples at the topography，between the small joint of same lumbar appear the bone substance not continuous，19 partial bone substance structure mess，increase thick.Conclusion? The normal CT check the dish of the lumbales，under the condition of not accompany overt dislocation，if at the topography，between the small joint of same lumbar appear the bone substance not continuous.The similar lumbar “break the tail”be like.And bone substance structure mess，increase the thick hour to increase to scan the scope，examined the spondylolysis the certain meaning to the early diagnosis.??? ??? 【Key words】? lumbar spine spondylolysis? tomography? X-ray computed??? ??? 腰椎椎弓峡部不连是引起腰腿痛的常见原因之一，成人发病率约6%。CT是诊断峡部不连的重要方法，但笔者通过追踪发现在基层医院，对一些腰椎峡部不连的患者在不伴有明显椎体移位的情况下常规CT检查时容易被忽略，原因是常见腰腿痛患者检查多以椎间盘平面扫描为主，易忽略峡部病变。本文对56例不伴有明显椎体移位的腰椎峡部不连患者CT表现进行回顾性分析。??? ??? 1? 资料与方法??? ??? 1.1? 一般资料? 本组男25例，女31例，年龄25～42岁，平均33.5岁。临床病史2个月～14年，56例均有不同程度腰痛史，其中伴单侧下肢放射痛13例，双侧下肢放射痛26例，直腿抬高试验阳性者36例，有明显外伤史15例。??? ??? 1.2? 方法? 采用美国PICKER-1200全身CT扫描机，按照常规腰椎间盘扫描检查，在腰椎侧位定位像上设定L3～S1椎间盘扫描基线，范围应包含椎间盘邻近上、下椎体边缘，必要时增加扫