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目的探讨16层螺旋 CT 对腰神经根多平面同层显示重建与腰椎间盘突出和/或膨出(LDHB)整体关系的影像学诊断价值,为临床相关疾病的诊断提供依据。方法共选31例(50个节段)均有典型 LDHB 临床症状及体征的患者,经 CT 扫描多平面重建,利用同层显示技术诊断为LDHB,后经手术及病理证实。使用美国 GE 公司制造的 Light Speed 16层螺旋 CT 扫描,在 ADW4.1工作站上,UNIX 操作系统对腰神经根进行多平面重建,取其同层显示层面分析其与椎间盘整体关系的异常表现。结果在同层显示下不仅清晰可见有无 LDHB,同时可表现整体神经根走行此处多项指标的异常变化,其中主要包括:二者有接触或接触的范围增大(100%)、神经根移位(96%)、形态学变化(94%)、粗细的变化(92%)、走行方向变化(88%)、密度的变化(80%)、硬膜囊与神经根夹角增大(76%)及其周围组织继发性等异常改变。随 LDHB 时间的延长,受压的神经根可表现由增粗到变细。结论 16层螺旋 CT 同层显示重建可十分理想地显示 LDHB 与神经根走行整体下的各种异常关系及大体判断神经根新旧损伤的病理变化。这一技术对 LDHB 的影像学诊断及临床治疗具有极大的应用价值。
Objective To explore the diagnostic value of 16-slice spiral CT in the imaging diagnosis of lumbar intervertebral disc herniation and / or bulging (LDHB) in the same layer of lumbar nerve root and to provide the basis for the diagnosis of clinically relevant diseases. Methods A total of 31 patients (50 segments) with typical LDHB clinical symptoms and signs were selected and reconstructed by multiplanar CT scan. LDHB was diagnosed by the same layer display technique and confirmed by operation and pathology. Using the Light Speed 16-slice spiral CT scanner manufactured by GE Company, on the ADW4.1 workstation, the UNIX operating system was used to reconstruct the lumbar nerve root by multiplanar reconstruction, and the anomalous manifestation of its relationship with the intervertebral disc was analyzed. The results showed that not only the LDHB but also the LDHB were clearly visible at the same level, meanwhile, there were abnormal changes of many indicators such as the increase of contact and contact (100%) between the two nerve roots, (96%), morphological change (94%), thickness change (92%), walking direction change (88%), density change (80%), dural sac and nerve root 76%) and its surrounding tissue secondary abnormalities such as changes. With LDHB time extension, compression of the nerve root can be manifested by the thickening to thinning. Conclusion The reconstruction of 16-slice spiral CT in the same layer shows the abnormal relationship between LDHB and the entire root of the nerve root and the pathological changes of the old and new nerve root lesions. This technique is of great value to LDHB imaging diagnosis and clinical treatment.