發(fā)布時(shí)間：2018-06-13 08:22

  本文選題：關(guān)節(jié)突交鎖 + 螺旋CT��； 參考：《中南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2015年10期

【摘要】：目的:探討脊柱椎關(guān)節(jié)突交鎖螺旋CT的多平面重建(multiplanar reconstruction,MPR)和三維(three dimension,3D)重建圖像的特點(diǎn)及在診斷中的作用。方法:選取本院近年來31例診斷為脊柱椎關(guān)節(jié)突交鎖的患者,回顧性分析其術(shù)前或牽引前的螺旋CT資料,同時(shí)進(jìn)行MPR和3D圖像重建;觀察關(guān)節(jié)突交鎖在軸位、MPR和3D重建的螺旋CT表現(xiàn),并評(píng)估軸位、MPR和3D重建圖像的優(yōu)勢。結(jié)果:31例患者影像中,軸位上呈現(xiàn)"反漢堡包"征者,頸椎損傷21例、胸腰段損傷10例。MPR矢狀面顯示下關(guān)節(jié)突與下方椎體上關(guān)節(jié)突形成頂對頂形態(tài),伴有患椎I°前滑脫及下關(guān)節(jié)突尖端骨折頸椎5例,胸腰段0例,均為單側(cè)交鎖;上方椎體下關(guān)節(jié)突越過下方椎體上關(guān)節(jié)突前移,形成背靠背形態(tài),伴有患椎II°~III°前滑脫,以雙側(cè)交鎖為主,頸椎雙側(cè)9例、單側(cè)6例,胸腰段雙側(cè)10例,并伴有下方椎體屈曲性淚滴樣骨折,頸椎7例、胸腰段3例;一側(cè)上、下關(guān)節(jié)突成背靠背形態(tài),一側(cè)上、下關(guān)節(jié)突成頂對頂形態(tài),頸椎1例。冠狀面,頸椎21例下關(guān)節(jié)突不同程度內(nèi)移,與下方椎體上關(guān)節(jié)突呈互相依托,或下關(guān)節(jié)突鎖于上關(guān)節(jié)凹內(nèi);胸腰段10例下關(guān)節(jié)突與上關(guān)節(jié)突同時(shí)出現(xiàn)或顯示下關(guān)節(jié)突明顯上移,關(guān)節(jié)結(jié)構(gòu)消失。3D重建圖像清楚顯示31例關(guān)節(jié)突交鎖,并通過不同面及不同角度旋轉(zhuǎn)顯示關(guān)節(jié)突交鎖的空間形態(tài),并可清晰地顯示椎體滑脫及旋轉(zhuǎn)程度。結(jié)論:MPR及3D重建顯示關(guān)節(jié)突交鎖較軸位清楚、直觀。脊柱關(guān)節(jié)突交鎖的螺旋CT的MPR和3D重建是軸位CT掃描有意義的補(bǔ)充,有助于本病的診斷,減少漏診,為臨床診療提供了有價(jià)值的影像信息。
[Abstract]:Objective: to investigate the features and diagnostic value of multiplanar reconstruction (MPRs) and three-dimensional three dimensional (3D) reconstruction of interlocking spiral CT (MSCT) in spinal vertebrae. Methods: Thirty-one patients with spinal interlocking were selected in our hospital in recent years. The spiral CT data before or before traction were analyzed retrospectively and MPR and 3D images were reconstructed simultaneously. The spiral CT findings of MPR and 3D reconstruction of interlocking articular processes were observed and the advantages of axial MPR and 3D reconstruction were evaluated. Results among the 31 cases, there were 21 cases of cervical spine injury and 10 cases of thoracolumbar injury. MPR sagittal plane showed that the inferior articular process and the superior articular process of the lower vertebrae formed the top to the top of the upper articular process of the lower vertebrae, the cervical spine injury in 21 cases, and the thoracolumbar segment injury in 10 cases. There were 5 cases of cervical spondylolisthesis before I 擄and 5 cases of fracture of the tip of inferior articular process, all of them were unilateral interlocking, and the inferior articular process of upper vertebral body moved forward across the superior articular process of the lower vertebral body to form a form of back to back, accompanied by spondylolisthesis before II 擄III 擄of the affected vertebrae. Bilateral interlocking was dominant, cervical vertebrae in 9 cases, unilateral in 6 cases, thoracolumbar segment in 10 cases, accompanied by teardrop fracture of the lower vertebral body, cervical vertebrae in 7 cases and thoracolumbar segment in 3 cases. The lower articular process was apical to apical, cervical vertebrae in 1 case. In the coronal plane, the lower articular process of the cervical vertebrae in 21 cases had different degrees of inward movement, which was dependent on each other with the superior articular process of the lower vertebral body, or was locked in the superior articular fovea of the lower articular process in the thoracolumbar segment of 10 cases, the lower articular process appeared simultaneously with the upper articular process or showed the obvious upward movement of the lower articular process. The disappearing of articular structure. 3D reconstruction image clearly showed the interlocking of articular process in 31 cases. The spatial shape of interlocking of articular process was displayed by rotation of different planes and angles, and the degree of spondylolisthesis and rotation of vertebral body could be clearly displayed. ConclusionTwo-one MPR and three-dimensional reconstruction showed the interlocking of articular process more clearly and intuitively than in axial position. MPR and 3D reconstruction of spiral CT with interlocking spine and articular process is a meaningful supplement to axial CT scan, which is helpful to the diagnosis of this disease, reduces missed diagnosis, and provides valuable imaging information for clinical diagnosis and treatment.
【作者單位】： 石家莊市第三醫(yī)院核磁CT室;
【分類號(hào)】：R687.3;R816.8

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本文編號(hào)：2013359