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目的:探讨三维CT对诊断颈椎病的价值。方法:采用三维CT技术检查300例颈椎病患者,观察颈椎骨质增生情况、椎间孔大小、椎动脉和颈椎骨质增生的关系、骨性椎管狭窄的改变。其中,神经根型145例,椎动脉型41例,脊髓型40例,混合型73例,食管压迫型1例。结果:21.3%的患者有颈椎椎体骨质增生,42.3%的钩突关节和16.2%的小关节突有骨质增生,有12个小关节突有错位改变。在145例神经根型颈椎病例中,发现椎间孔狭窄438处。其中,C6/7和C5/6椎间孔狭窄占81.3%。椎间孔狭窄的原因有钩突关节骨质增生、椎间盘突出、椎体肥大、小关节突骨增生/错位等。椎动脉型颈椎病表现为骨赘压迫椎动脉(22.0%)、椎动脉变细或粗细不均(51.2%)和椎动脉迂曲(14.7%)。脊髓型颈椎病三维CT表现为颈椎椎管狭窄、椎体后缘骨质增生、后纵韧带钙化、椎间隙狭窄和颈椎间盘突出等。结论:三维CT能全面评价颈椎间盘退变及其产生的颈椎骨质增生对神经、血管和脊髓的影响,是一种诊断颈椎病的实用影像学检查方法。
Objective: To investigate the value of three-dimensional CT in the diagnosis of cervical spondylosis. Methods: 300 cases of cervical spondylosis were examined by three-dimensional computed tomography (CT). The bone hyperplasia in cervical spine, the size of intervertebral foramina, the relationship between vertebral artery and cervical hyperosteogeny and the change of bony spinal canal stenosis were observed. Among them, there were 145 nerve root types, 41 vertebral artery types, 40 spinal type, 73 mixed type and 1 esophageal compression type. Results: 21.3% of the patients had cervical vertebral hyperosteogeny, 42.3% of the uncinate process and 16.2% of the facet joints had hyperosteogeny. There were 12 facet joints with dislocation change. In 145 cases of radiculopathic cervical spondylosis, 438 foraminal stenoses were found. Among them, C6 / 7 and C5 / 6 foraminal stenosis accounted for 81.3%. The causes of foraminal stenosis are osteomalacia hyperostosis, disc herniation, vertebral hypertrophy, facet joint hyperplasia / dislocation and so on. Vertebral artery type cervical spondylosis showed osteophyte compression of the vertebral artery (22.0%), vertebral artery thinning or uneven thickness (51.2%) and tortuous vertebral artery (14.7%). Cervical spondylotic myelopathy three-dimensional CT showed cervical spine stenosis, vertebral bone hyperplasia, posterior longitudinal ligament calcification, intervertebral space stenosis and cervical disc herniation. Conclusion: Three-dimensional CT can fully evaluate the effect of cervical disc degeneration and cervical spine hyperplasia on nerves, blood vessels and spinal cord. It is a practical imaging diagnosis method for cervical spondylosis.