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目的探讨多层螺旋CT轴向负荷(ACE)检查对腰椎隐匿性中央椎管狭窄(OCSS)的诊断价值。资料与方法选择临床有神经根功能缺陷症状而常规CT(PRP)检查无明显神经根、硬膜囊压迫征象的50例患者进一步作PRP和ACE检查。分别测量下腰椎3个平面两种检查硬膜囊面积(DCSA)。结果50例中无椎间盘膨出(A组)33个平面,PRP检查未发现DCSA<75 mm2平面,负荷后3个平面DCSA<75 mm2。117个椎间隙伴椎间盘膨出或突出(B组),PRP检查8个平面DCSA<75 mm2,负荷后33个平面DCSA<75 mm2。负荷后B组OCSS明显多于A组(P<0.01)。结论多层螺旋CTACE检查能够发现PRP检查未能发现的OCSS,提高了椎管狭窄的诊断率。
Objective To investigate the diagnostic value of multislice spiral CT axial load (ACE) in the diagnosis of occult lumbar spinal canal stenosis (OCSS). Materials and Methods Fifty patients with clinical symptoms of radicular defects and conventional CT (PRP) examination without signs of nerve root or dural sac compression were selected for further PRP and ACE testing. The three dorsal planes of the lower lumbar spine were examined for dural sac area (DCSA). Results There were 33 planes without disc bulging in group A (50 cases), no plane of DCSA <75 mm2 in PRP group, 3 cases of DCSA <75 mm2. PRP examined eight planar DCSA <75 mm2 and 33 planar DCSA <75 mm2 loaded. OCSS in group B after loading was significantly higher than that in group A (P <0.01). Conclusions Multislice spiral CTACE can detect the OCSS which can not be found by PRP and improve the diagnosis rate of spinal canal stenosis.