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轴向负荷装置的制作及其在腰椎管狭窄CT诊断中的应用(1)
http://www.100md.com 2009年7月25日 潘献伟
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     [摘要] 目的:评估自制轴向负荷装置在腰椎管狭窄CT诊断中的应用价值。方法:应用帆布、踏板秤及松紧扣自制一个简易的轴向负荷装置,对41例经临床及CT检查证实的腰椎管狭窄患者先行常规扫描,然后施加约50%自重行轴向负荷扫描,测量轴向负荷前、后椎管狭窄平面脊膜囊截面积并进行统计学处理。结果:41例患者中共有56个椎管狭窄平面,分别为L3~4 5个,L4~5 21个,L5~S1 30个;其轴向负荷前、后狭窄平面脊膜囊截面积平均值分别为(93.7±4.1) mm2与(82.7±9.3) mm2、(85.2±11.6) mm2与(78.1±16.5) mm2、(84.9±11.0) mm2与(75.7±16.1) mm2,各平面轴向负荷后脊膜囊截面积均缩小,差异有统计学意义。结论:轴向负荷后CT检查能如实地反映椎管狭窄的情况,在腰椎管狭窄的诊断中有独特价值。

    [关键词] 轴向负荷;螺旋CT;腰椎;椎管狭窄

    [中图分类号]R445.3 [文献标识码] B[文章编号] 1673-7210(2009)07(c)-085-03

    Manufacture of the axial loading device and its application in the diagnosis of lumbar spinal stenosis with CT

    PAN Xianwei

    (Department of CT, the Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China)

    [Abstract] Objective: To assess the value of axial loading device in the diagnosis of lumbar spinal stenosis with CT. Methods: To make a simple axial loading device with canvas, pedal scale and strainers. 41 cases of lumbar spinal stenosis who had been confirmed by clinical and CT examination, were given conventional scanning first, and then axial loading scanning with about 50% body weight, the sac cross-sectional area of stenosis plane of the spinal canal was measured, carried out the statistical analysis. Results: 41 cases of patients with spinal stenosis total of 56 planes, L3-4 5 planes, L4-5 21 planes, L5-S1 30 planes; and the sac cross-sectional area before and after axial loading were on average (93.7±4.1) mm2 and (82.7±9.3) mm2, (85.2±11.6) mm2 and (78.1±16.5) mm2, (84.9±11.0) mm2 and (75.7±16.1) mm2, the sac cross-sectional area were reduced after axial loading, there were significant differences. Conclusion: CT examination after the axial loading can accurately reflect the situation of spinal stenosis, and have unique value in the diagnosis of lumbar spinal stenosis.

    [Key words] Axial load; Spiral CT; Lumbar; Spinal stenosis

    近年来,应用轴向负荷装置研究腰椎管狭窄在脊柱影像学领域里已有较多报道。国外一些学者[1-4]通过较复杂的机械装置(如Dyna Well L-spine)向腰椎施加轴向负荷,在MRI及CT检查中模拟人体直立位轴向负重的生理状态,对腰椎管狭窄症患者进行研究后指出:与常规检查比较,椎管狭窄程度加重,如椎间盘膨出或突出明显、黄韧带变肥厚、硬膜囊后脂肪垫前突及诱发小关节滑膜囊肿等,导致硬膜囊截面积进一步缩小,神经根受压加剧,因而能较真实地反映椎管的狭窄及神经根受压的情况,从而影响临床医生的治疗决定 ......

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