CT检查腰椎间盘突出关节不对称性病变的临床价值
The clinical value of multi row multi-row spiral CT in evaluating the symmetry of facet joints in patients with lumbar disc herniation
郑亮 1廖杰 1郑新一 1覃飞2
作者信息
- 1. 四川省成都市温江区中医医院放射科 四川 成都 611130
- 2. 四川省成都市第五人民医院放射科 四川 成都 611130
- 折叠
摘要
目的 探讨CT检查对腰椎间盘突出患者关节不对称病变的临床价值.方法 选取腰椎间盘突出患者 90 例作为观察组,另选同期健康人群 90 例作为对照组,观察两组腰椎间盘关节不对称性发生率,并测评双侧关节突关节角度值及双侧角度差值.结果 观察组CT检查显示病变关节突关节间隙变窄,骨质增生硬化,关节突关节囊内积液、积气,关节韧带肥厚,伴有脊柱前移的关节突关节不稳及半脱位,关节突关节不同程度偏向矢状位或偏向水平位;对照组关节突关节间隙不窄,骨质光滑均匀,左右关节突呈现对称性.观察组L4～5、L5～S1 节段左侧、右侧关节突关节角度值为(43.73±4.28)mm、(10.51±1.60)mm,(47.28±5.93)mm、(10.89±1.70)mm,均高于对照组(37.05±4.04)mm、(4.90±1.03)mm,(41.95±5.11)mm、(4.37±1.26)mm,差异有统计学意义(P<0.05).观察组L3～4、L4～5、L5～S1 节段双侧关节突关节不对称发生率为 20.00%、34.44%、40.00%,均高于对照组 7.77%、8.89%、6.67%,差异有统计学意义(P<0.05),观察组CT分级 4 级 17 例、3 级 21 例、2 级 52 例.结论 CT扫描能够对关节突关节进行角度测量,评估其对称性,可准确反映腰椎间盘突出患者的关节突关节对称的改变程度.
Abstract
Objective To use CT to scan the facet joints of the patients with lumbar disc herniation,to observe the occur-rence of bilateral facet joint asymmetry,and to evaluate the change of the angle of the joint disease,and to provide the basis for the clinical diagnosis.Methods 90 patients with lumbar disc herniation from October 2022 to March 2024 were selected as the observation Group,and 90 healthy patients in the same period were selected as the control group.The incidence of joint asymme-try was observed,and the value of bilateral facet joint angle and bilateral angle difference were measured.Results CT in the ob-servation group showed narrow joint space,bone hyperplasia and sclerosis,fluid and gas accumulation in joint capsule,joint ligament hypertrophy,instability and subluxation,sagittal or horizontal position;the control group was not narrow,the bone was smooth and even,and the left and right joint processes were symmetrical.The angles of the left and right facet joints of L4-5 and L5-s 1 segments in the observation group were(43.73±4.28)mm,(10.51±1.60)mm,(47.28±5.93)mm,(10.89±1.70)mm,compared higher than the control group(37.05±4.04)mm,(4.90±1.03)mm,(41.95±5.11)mm,(4.37±1.26)mm,the difference was significant(P<0.05).The incidence of bilateral facet joint asymmetry at L3-4,L4-5,L5-s1 segments in the observation group was 20.00%,34.44%and 40.00%,higher than that in the control group of 7.77%,8.89%,6.67%,the differ-ence was significant(P<0.05).In Observation Group,there were 17 cases with 4 grades,21 cases with 3 grades and 52 cases with 2 grades.Conclusion CT scan can measure the angle of facet joint and evaluate its symmetry,which can reflect the change of facet joint symmetry accurately in patients with lumbar disc herniation.
关键词
腰间盘突出/关节突关节/对称性/体层摄影术,X线计算机Key words
Lumbar disc protrusion/Joint process joint/Symmetry/Tomography,X-ray computed引用本文复制引用
基金项目
四川省基层卫生事业发展研究中心课题(SWFZ22-Y-31)
四川省成都市医学科研项目(2023AH091353)
出版年
2024
NETL
NSTL
万方数据