螺旋CT薄层加扫在游离型腰椎间盘突出诊断中应用价值.docVIP

螺旋CT薄层加扫在游离型腰椎间盘突出诊断中应用价值[摘要] 目的 探讨常规腰椎CT扫描加薄层螺旋CT扫描在游离型腰椎间盘突出诊断中的应用价值。方法 对14例游离型椎间盘突出患者的常规腰椎CT及在可疑椎间盘的下部或上部层面进行连续薄层扫描的图像进行分析。结果 常规腰椎CT扫描：8例椎间盘层面未见软组织突出影，4例椎间盘层面见环形膨出影，2例在椎间盘的下部层面见弧形突出的软组织影。薄层螺旋CT扫描：清晰显示突向椎管内的软组织密度影。结论 薄层扫描对诊断游离型腰椎间盘突出有着重要意义，是避免游离型腰椎间盘突出漏诊的重要扫描方法，特别是基层医院，为临床治疗方法选择提供重要的参考。 [关键词] 腰椎间盘突出症游离型；薄层扫描；椎间盘移位；X线计算机 [中图分类号] R445.3[文献标识码] B[文章编号] 1673-9701（2011）21-94-02 Application of Spiral CT Shallow Scanning in Sequestered Lumbar Disc Herniation HAO Guoxiang XU Xinyu GUAN Caixiu GAO Yantao Department of CT Radiology，Yutian County Family Planning Center Hospital of Hebei Province，Yutian 064100，China [Abstract]Objective To evaluate the diagnostic value of the spiral CT shallow scanning in sequestered lumbar disc. Methods Images of 14 cases of the sequestered lumbar disc herniation （SLDH）by conventional CT scanning and the images by spiral CT shallow scanning on the front lumbar disc or the behind lumbar disc of the suspiciously pathological lumbar disc were analyzed. Results In the conventional CT scanning images，there are 8 cases which the soft tissue density didnt appear，4 cases which annular and projecting density appeared，and 2 cases which arc and projecting soft tissue density appeared on the layer behind the lumbar disc. In the images of spiral shallow scanning，it is clear to show the soft tissue density projecting into the spinal canal. Conclusion It is significant to diagnosis SLDH. And it is a good method to avoid missing on the diagnostic of SLDH. Especially in primary hospital，it provides an important method for the methods selecting of clinical treatment. [Key words] Sequestered lumbar disc herniation；Spiral CT shallow scanning；Intervertbral disk displacement；X-ray computed 游离型腰椎间盘突出症（sequested lumbardisc disc herniation，SLDH）是指髓核碎片突破纤维环及后纵韧带，游离于椎管内、硬膜外的腰椎间盘突出症[1]，可压迫神经根或马尾神经而引起相应症状。由于髓核碎片离开椎间隙平面，往往为常规CT扫描遗漏，是造成普通CT假阴性的重要原因[2]。本文报道14例经MRI及手术证实的游离型腰椎间突出症的常规CT扫描与相邻椎体上下缘薄层扫描影像表现，探讨其诊断价值。 1资料与方法 1.1一般资料 搜集2008年1月~2010年5