论文部分内容阅读
目的:探讨多层螺旋CT图像后处理技术对腰椎峡部裂的诊断价值。方法:应用多层螺旋CT机对43例腰椎峡部裂患者的腰椎进行扫描,利用多平面重建(MPR)、最大密度投影(MIP)、容积显示技术(VRT)进行多模式图像后处理,多方位观察患者椎弓峡部裂情况。结果:43例患者中共发现83个椎弓峡部裂,双侧32例,其中4例累及两个脊椎的双侧椎弓;单侧11例。腰椎斜矢状位MPR及平行于椎弓的轴位MPR能够诊断全部病例,13例裂隙呈不规则锯齿状,边缘清晰,9例边缘骨质硬化、膨大;12例伴有碎骨块,并见裂隙周围纤维组织增生。正中矢状位MPR发现脊椎向前滑脱22例,其中Ⅰ度滑脱16例,Ⅱ度滑脱5例,Ⅲ度滑脱1例。7例出现假性椎间盘膨出征,硬膜囊向前移行。MIP也能全部显示所有病例的峡部裂,但是对软组织观察不如MPR。高密度VRT仅发现峡部裂23例39处。结论:多层螺旋CT扫描后MPR、MIP及VRT图像后处理技术能够全方位评价腰椎峡部裂的形态变化,为临床提供与峡部裂有关的更多更详细的影像信息,MPR是最有价值的重建方法。
Objective: To investigate the diagnostic value of multislice CT postprocessing in the diagnosis of lumbar spondylolysis. Methods: Forty-three patients with lumbar spondylolysis were scanned by multi-slice spiral CT, multi-modality images were processed by multiplanar reconstruction (MPR), maximum density projection (MIP) and volumetric display (VRT) Observation of patients with spondylolysis. RESULTS: Totally 83 vertebral pedicles were found in 43 cases, with 32 cases on both sides. Four cases involved the bilateral vertebrae of both vertebrae and 11 cases unilateral. MPR of lumbar oblique sagittal plane and MPR parallel to pedicle axis were able to diagnose all the cases. Thirteen fissures were irregularly serrated with sharp edges. Nine of them had border bone sclerosis and enlargement. See the fibrous tissue around the crack hyperplasia. In the median sagittal MPR, the spondylolisthesis was found in 22 cases, including 16 cases of grade Ⅰ spondylolisthesis, 5 cases of grade Ⅱ spondylolisthesis and 1 case of grade Ⅲ spondylolisthesis. Seven cases of pseudo-intervertebral disc bulge syndrome, dural sac to move forward. MIP also showed all isthmus fragmentation in all cases, but not as good as soft tissue observation for MPR. In high-density VRT, only 23 cases of isthmus were found in 23 cases. Conclusion: MPR, MIP and VRT post-processing techniques can evaluate the morphological changes of lumbar spondylolysis comprehensively after multi-slice spiral CT scan. MPR is most valuable in clinical practice to provide more detailed image information related to isthmus fragmentation Reconstruction method.