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1、多层螺旋CT及多平面重组在脊柱结核诊断中应用【摘要】目的探讨多层螺旋CT及多平面重组在脊柱结核诊断中的应用价值。方法回顾分析间经多层螺旋CT及多平面重组检查诊断,并经临床、手术及病理检查证实的125例脊柱结核。结果125例脊柱结核中多层螺旋CT及多平面重组共显示累及颈椎者5例,占4%,累及颈胸段者2例,占1.6%,累及胸椎者29例,占23.2%,累及胸腰段者10例,占8%,累及腰椎者72例,占57.6%,累及腰骶段者7例,占5.6%。其中125例骨质破坏,27例死骨形成,75例椎旁或腰大肌脓肿,78例椎间盘破坏,35例骨性椎管狭窄。结论脊柱结核的传统X线检查,有其明显局限性,多层螺旋CT及多
2、平面重组可清晰显示骨质破坏的细节,死骨、脓肿及钙化的形成,椎间盘的破坏,对病变范围、椎管狭窄及脊髓压迫的情况有明显的显示优越性。这二者的结合已成为目前脊柱结核的有效影像诊断方法。【关键词】脊柱结核;多层螺旋CT;多平面重组;骨质破坏;影像诊断ValueofmultilayerhelicCTandmulti-panarreconstructionindiagnosisofspinaltuberculosisLIBo,ZHAOZe-gang,LUOJun-hua,etal.10DepartmentofRadiologyandepidemiology,PublicSecaityHospitalof
3、BeijingMunicipal;DepartmentofRadiology,BeijingChestHospital,Beijing100023,China【Abstract】ObjectiveToevaluatethevalueofmultilayerhelicCTandmulti-panarreconstructionindiagnosisofspinaltuberculosis.MethodsToanalyzethefindingsofmultilayerhelicCTandmulti-panarreconstructionofonehundredandtwenty-fivecase
4、sofspinaltuberculosisconfirmedbyoperation,pathologyandclinicsymptom.ResultsIn125cases,thelesionlocatedincervicalvertebraehad5cases(4%),2casesincervicothoracicspinaltuberculosis(1.6%),29casesinthoracicspinaltuberculosis(23.2%),10casesinthoracolumbarspinaltuberculosis(8%),72casesinlumbarspinaltubercu
5、losis(57.6%),7casesinlumbarsacrumspinaltuberculosis(5.6%).Allof125caseshadbonedestruction,27caseshadsequsetrum,75caseshadsofttissuemasses,78caseshadvertebraldiscdestruction,35caseshadspinalcanalstenosis.ConclusionTheX-rayofspinal10tuberculosishavelocalization,multilayerhelicCTandmulti-panarreconstr
6、uctionhaveclearfindingsofbonedestruction,sequsetrum,tissuemassesandcalcificationandvertebraldiscdestruction,theyalsohavetheobvioussuperiorityintheareaoflesion,spinalcanalstenosisandtheoppressionofspinalcord.TheconnectionofmultilayerhelicCTandmulti-panarreconstructionhavebeentheeffectivetechniqueind
7、iagnosisofspinaltuberculosis.【Keywords】Spinaltuberculosis;MultilayerhelicCT;Multi-panarreconstruction;Bonedestruction;Imagingdiagnosis作者单位:100023北京市公安医院(监区医疗管理处)放射科(李波张国华),传染科(罗君华谢小雁王丽萍);北京市胸科医院放射科(赵泽刚)10近年
