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目的探讨螺旋CT旁矢状位重建对腰椎间孔狭窄的诊断价值。方法2003-01～2004-04,对腰腿疼患者临床和常规CT检查考虑有椎间孔狭窄时,使用螺旋CT旁矢状位二维重建,诊断并手术腰椎间孔狭窄症15例。结果15例螺旋CT旁矢状位重建均显示有L4～5或L5～S1椎间孔狭窄,2例极外侧型椎间盘突出,8例椎体终板后外缘局限性增生骨化突入椎间孔,1例腰椎滑脱峡部裂假关节,4例后外侧椎间盘突出间隙狭窄并黄韧带肥厚小关节增生、上移。水平狭窄型7例,垂直狭窄型8例。Ⅱ度狭窄6例,Ⅲ度狭窄9例。结论螺旋CT旁矢状位重建可以弥补常规横断CT扫描的不足,对椎间孔显示清晰直观,对手术减压有定位指导意义,有较高诊断价值。
Objective To investigate the value of spiral CT in the diagnosis of lumbar intervertebral foramina. Methods From January 2003 to April 2004, 15 cases of lumbar intervertebral stenosis were diagnosed and treated by two dimensional reconstruction of paravertebral sagittal spiral CT with clinical and routine CT examination of lumbar and leg pain. Results 15 cases of spiral CT sagittal reconstruction showed L4 ~ 5 or L5 ~ S1 foraminal stenosis, 2 cases of extreme lateral disc herniation, 8 cases of vertebral end plate marginal peripheral hyperplasia ossification into the intervertebral space 1 case of lumbar spondylolisthesis fissure joint, 4 cases of posterior lateral disc herniation space narrowing and ligamentum flavum thickening of the small joints, up. 7 cases of horizontal stenosis, 8 cases of vertical stenosis. Ⅱ degree stenosis in 6 cases, Ⅲ degree stenosis in 9 cases. Conclusion The reconstruction of paravertebral CT scan can make up for the lack of routine CT scan, display clear and direct visualization of the intervertebral foramina and guide the decompression of the operation, which is of great diagnostic value.