脊柱关节突交锁螺旋CT的多平面重建和三维重建

发布时间：2018-06-13 08:22

本文选题：关节突交锁 + 螺旋CT　；参考：《中南大学学报(医学版)》2015年10期

【摘要】：目的:探讨脊柱椎关节突交锁螺旋CT的多平面重建(multiplanar reconstruction,MPR)和三维(three dimension,3D)重建图像的特点及在诊断中的作用。方法:选取本院近年来31例诊断为脊柱椎关节突交锁的患者,回顾性分析其术前或牵引前的螺旋CT资料,同时进行MPR和3D图像重建;观察关节突交锁在轴位、MPR和3D重建的螺旋CT表现,并评估轴位、MPR和3D重建图像的优势。结果:31例患者影像中,轴位上呈现"反汉堡包"征者,颈椎损伤21例、胸腰段损伤10例。MPR矢状面显示下关节突与下方椎体上关节突形成顶对顶形态,伴有患椎I°前滑脱及下关节突尖端骨折颈椎5例,胸腰段0例,均为单侧交锁;上方椎体下关节突越过下方椎体上关节突前移,形成背靠背形态,伴有患椎II°~III°前滑脱,以双侧交锁为主,颈椎双侧9例、单侧6例,胸腰段双侧10例,并伴有下方椎体屈曲性泪滴样骨折,颈椎7例、胸腰段3例;一侧上、下关节突成背靠背形态,一侧上、下关节突成顶对顶形态,颈椎1例。冠状面,颈椎21例下关节突不同程度内移,与下方椎体上关节突呈互相依托,或下关节突锁于上关节凹内;胸腰段10例下关节突与上关节突同时出现或显示下关节突明显上移,关节结构消失。3D重建图像清楚显示31例关节突交锁,并通过不同面及不同角度旋转显示关节突交锁的空间形态,并可清晰地显示椎体滑脱及旋转程度。结论:MPR及3D重建显示关节突交锁较轴位清楚、直观。脊柱关节突交锁的螺旋CT的MPR和3D重建是轴位CT扫描有意义的补充,有助于本病的诊断,减少漏诊,为临床诊疗提供了有价值的影像信息。
[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 掳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 掳III 掳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.
【作者单位】：石家庄市第三医院核磁CT室;
【分类号】：R687.3;R816.8

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