多层螺旋CT在脊柱结核诊断中的临床应用研究
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摘要
目的探讨多层螺旋CT(MSCT)在脊柱结核诊断中的临床应用研究。方法 56例脊柱结核术前均行MSCT扫描,并作多平面重建(MPR)。将图像与手术中和病理学检查证实对照,评价MSCT在评估脊柱骨质破坏程度、破坏类型、周围软组织肿胀、椎管受压、椎体滑脱程度的价值。结果 MSCT图像对脊柱骨质破坏程度及类型、周围软组织肿胀、椎管受压、脊髓受侵犯、椎体滑脱程度的显示与术中一致。56例手术全部成功,23例单纯病灶清除术,17例行内固定术,13例病灶清除加人工骨植入术,3例病灶清除加椎体滑脱复位术后钢板内固定术。结论 MSCT直观、准确地显示脊柱结核的病情程度,是临床术前制订手术方案起着决定性作用。
Objective To explore the clinical application of multi-slice spiral CT(MSCT)in the diagnosis of spinal tuberculosis.Methods MSCT scan and MPR were performed in 56 cases of spinal tuberculosis before operation.The value of MSCT in evaluating the degree of spinal bone destruction,destruction type,surrounding soft tissue swelling,spinal canal compression and spondylolisthesis was evaluated. Results MSCT images showed the degree and type of spinal bone destruction, surrounding soft tissue swelling,spinal canal compression,spinal cord invasion and spondylolisthesis in accordance with the intraoperative findings.Fifty-six cases were successfully operated,23 cases were treated with focal debridement alone,17 cases were treated with internal fixation,13 cases were treated with focal debridement and artificial bone implantation,and 3 cases were treated with plate internal fixation after focal debridement and reduction of spondylolisthesis. Conclusion MSCT visually and accurately shows the degree of spinal tuberculosis,which plays a decisive role in the preoperative surgical planning.
Objective To explore the clinical application of multi-slice spiral CT(MSCT)in the diagnosis of spinal tuberculosis.Methods MSCT scan and MPR were performed in 56 cases of spinal tuberculosis before operation.The value of MSCT in evaluating the degree of spinal bone destruction,destruction type,surrounding soft tissue swelling,spinal canal compression and spondylolisthesis was evaluated. Results MSCT images showed the degree and type of spinal bone destruction, surrounding soft tissue swelling,spinal canal compression,spinal cord invasion and spondylolisthesis in accordance with the intraoperative findings.Fifty-six cases were successfully operated,23 cases were treated with focal debridement alone,17 cases were treated with internal fixation,13 cases were treated with focal debridement and artificial bone implantation,and 3 cases were treated with plate internal fixation after focal debridement and reduction of spondylolisthesis. Conclusion MSCT visually and accurately shows the degree of spinal tuberculosis,which plays a decisive role in the preoperative surgical planning.
引文
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[4]李波,赵泽刚,罗君华,等.多层螺旋CT及多平面重组在脊柱结核诊断中的应用[J].中国实用医药,2010.5(13):14-15.
[5]Arslantas A,Faruk A,Kismet B,et al.Intramedullary tuberculoma of the spinal cord[J].J Postqrad Med,2002,48:54-55.
[6]李前.脊柱结核的CT分析及其应用价值[J].现代医用影像学,2008,17,4,96:201-202.
[2]韩萍,于春水.医学影像诊断学[M].北京:人民卫生出版社,2018,4,4:577-578.
[3]张和平,李传亭,王长福,等.椎管内结核的MRI表现[J].中华放射学杂志,2008,12,42,12:1330-1331.
[4]李波,赵泽刚,罗君华,等.多层螺旋CT及多平面重组在脊柱结核诊断中的应用[J].中国实用医药,2010.5(13):14-15.
[5]Arslantas A,Faruk A,Kismet B,et al.Intramedullary tuberculoma of the spinal cord[J].J Postqrad Med,2002,48:54-55.
[6]李前.脊柱结核的CT分析及其应用价值[J].现代医用影像学,2008,17,4,96:201-202.