摘要
目的评估轴向负荷CT检查对腰椎间孔的影响及其临床意义。方法45例慢性腰腿痛患者进行了常规CT检查和轴向负荷CT检查,其中坐骨神经痛13例,神经性跛行10例。结果常规CT检查共发现102个（28.8%）椎间孔狭窄,其中轻度狭窄（1级）64个,中度狭窄（2级）33个,重度狭窄（3级）5个。而轴向负荷检查共发现122个（34.5%）椎间孔狭窄,其中轻度狭窄75个,中度狭窄40个,重度狭窄7个（χ^2=2.70,P〉0.05）。与常规CT检查比较,轴向负荷检查可导致L2/3、L3/4、L4/5椎间孔面积呈不同程度的缩小（P〈0.05）,平均缩小6.2-10.6 mm^2,占椎间孔面积的8.1%~11.6%,而L5/S1水平椎间孔面积无显著变化（P〉0.05）。结论与常规CT检查方法比较,轴向负荷检查能引起椎间孔面积缩小,能发现常规CT检查所不能发现的椎间孔狭窄,能更准确的评估椎间孔狭窄的程度,对提高椎间孔狭窄的诊断具有一定的临床意义。
Objective To evaluate the effect of axially loaded CT on neural foramina and its clinical value. Methods Conventional CT and axially loaded CT examination were performed in 45 patients with low back pain, including 13 patients with sciatica and 10 patients with neurogenic claudication. Results Foraminal stenosis were found in 102 instances （28.8%） on conventional CT, including grade 1 foraminal stenosis 64 instances, grade 2 foraminal stenosis 33 instances, and grade 3 fo ramina 1 stenosis 5 instances, however, foraminal stenosis were found in 122 instances （34.5 %） on axially loaded CT, including gradel foraminal stenosis 75 instances, grade 2 foraminal stenosis 40 instances, and grade 3 foraminal stenosis 7 instances （X^2 = 2.70, P〉0.05）. Compared with conventional CT, neural foraminal area was decreased at L2/3, L3/4and L4/ 5 level on axially loaded CT （P〈0.05）, the mean reduction of foraminal area was 6.2--10.6 mm^2 , about 8.1%--11.6% of the total foraminal area. No significant change in foraminal area was demonstrated on axially loaded CT at L5/S1 level （P〉 0.05）. Conchtsion As compared with conventional imaging methods, axially loaded imaging can lead to the decrease of foraminal area, can found foraminal stenosis that can not be detected on conventional CT, and can accurately appreciated the severity of foraminal stenosis. It is of clinical value to improve the diagnosis of foraminal stenosis.
出处
《中国医学影像技术》
CSCD
北大核心
2007年第9期1382-1385,共4页
Chinese Journal of Medical Imaging Technology
基金
广东省医学科研基金资助项目(A2006195)
关键词
体层摄影术
X线计算机
腰椎
轴向负荷
椎间孔
Tomography, X-ray computed
Lumbar spine
Axially loaded
Intervertebral foramen
