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目的:探讨硬膜外造影后CT(CT-E)对腰椎管狭窄症的诊断价值及影像特征。方法:对27例腰椎管狭窄症患者行腰椎X线平片及单纯CT检查后再行CT-E检查。CT-E扫描椎体下1/3、椎间隙、椎体上缘平面,结合单纯CT及手术所见行对比分析。结果:CT-E诊断中央管狭窄3例,中央管伴侧隐窝狭窄2例,侧隐窝狭窄16例,神经根管狭窄4例,椎间孔狭窄2例。与手术所见吻合25例,诊断准确率达93%;单纯CT与手术所见吻合23例,诊断准确率为85%。结论:CT-E对腰椎管狭窄症更具有定性、定位诊断作用,可为有限化手术提供依据。
Objective: To investigate the diagnostic value and imaging features of CT (E-CT) after lumbar spinal stenosis. Methods: Twenty-seven patients with lumbar spinal stenosis underwent plain radiography and CT scan before CT-E examination. CT-E scan the vertebral body 1/3, intervertebral space, the upper edge of vertebral plane, combined with simple CT and surgery to see comparative analysis. Results: CT-E had 3 cases of central canal stenosis, 2 cases of central canal with lateral recess stenosis, 16 cases of lateral recess stenosis, 4 cases of nerve root canal stenosis and 2 cases of foraminal stenosis. Twenty-five cases were consistent with the surgical findings, and the diagnostic accuracy rate was 93%. Twenty-three cases were coincident with the surgical findings, and the diagnostic accuracy rate was 85%. Conclusion: CT-E is more qualitative and localized diagnosis of lumbar spinal stenosis and may provide the basis for limited surgery.