脊柱爆裂骨折的X线与CT诊断及评价.pdfVIP

2000 3 15 2 Radiol Practice, March 2000, Vol 15, No.2 1 1 X CT 陈珑 冷考远 = :分析脊柱爆裂骨折的X 线CT 表现, 并评价其诊断价值和限度以及对临 治疗中的指导作用: 回顾性分析98 例脊柱爆裂骨折的影像表现和临 资料, 其中颈椎 12 例,胸椎 16 例, 胸腰椎交界 50 例, 腰椎 20 例; 男65 例, 女33例, 平均年龄35岁外伤后全部摄取 X 线正侧位片; 73 例行 CT 平扫,其中34 例行 CT 多平面重建:X 线CT 表现为椎体高度减低终板骨折移位突入椎管内椎板骨折椎体侧突成角后移椎管狭窄小关节脱位, 棘突间或 椎弓根间距增大脊髓受压改变椎间盘突出及椎旁软组织变化: 投照质量良好的平片对脊柱爆裂骨折的诊断有 一 定价值,但需与单纯性压缩骨折鉴别, 明确诊断需CT 证实CT 能较清楚显示脊柱的三柱结构, 对脊柱爆裂性骨折能做出 较全面准确的诊断, 尤其是对骨折线显示小关节脱位椎管损伤及稳定性的判断 CT 有着明显的优越性平片对脊柱爆 裂骨折的指导治疗作用不大,CT 对其有 一定的价值但由于对椎间盘损伤脊髓受损及椎旁软组织显示的局限性, 其对 治疗指导有 一定的限度 = 脊椎 爆裂骨折 平片 计算机断层扫描 X- ray and CT diagnosis and evaluation of the vertebral burst fractures Chen Long,Leng Kaoyuan. Depart ent of CT, the First Hospital of Yichang,Hubei 443000 = Abstract Objective: To analyzeX-ary and CT findings and evaluate the clinical value and li itation of X-ray and CT in diagnosis and directing anage ent of vertebral burst fractures ( VBF). Methods: The i aging features and clinical data of 98 VBF were analyzed,including cervical vertebrae ( n= 12), thoracicvertebrae ( n= 16), thoracolu bar area ( n= 50) and lu bar vertebrae in 20 cases. There were 65 ales and 33 fe ales.The average agewas 35 years.Anteroposterior and lateral radiographs were taken in all patients,while CT scan in 73 cases, in 34 of which ult-i planar reconstruction was ade.Results:X-ary and CT findings showed decrease of vertebral height, displace ent of fractured end-plate with protruding into the spinal canal, la inar fracture, narrowed canal,spinal cord co pression,dislocation of thezygapophyseal joints,increase of interspinous or interpediculate distance and discherniations. Conclusions: Plain fil has so evalues in diagnosis of VBF.Precise diagnosis can be adeby CT. CT could display thethree colu ns structure of spine. Co pared with plain fil ,CT provides further infor ation on fractureline, di