ISSN 1004-4140
CN 11-3017/P

提高影像学检查在腰椎小关节退变损伤中的临床认识

Improved Imaging in Lumbar Facet Joint Degeneration in the Clinical Understanding

  • 摘要: 目的:提高影像学检查在腰椎小关节退变损伤中的临床认识。资料与方法:回顾性对比85例腰椎小关节退变损伤患者的X线平片、CT、MRI影像学资料,分别在关节面增生、关节面平整度、关节间隙变窄或真空征及小关节突骨质、关节脱位、关节突骨折、黄韧带钙化、关节面下软骨退变、关节囊肿胀、滑膜囊肿及滑膜囊疝等显示方面进行比较;并将退变引起椎体滑脱患者,在滑脱程度、部位及类型上诊断结果与手术结果对照。结果:CT在关节面增生、关节面平整度、关节间隙变窄或真空征、小关节突骨质、关节脱位、关节突骨折及黄韧带钙化等显示优于X线平片和MRI;MRI在关节面下软骨退变、关节囊肿胀、滑膜囊肿及滑膜囊疝等显示明显优于X线平片和CT;X线平片在小关节突增生、肥大、变尖、骨赘形成及关节间隙变窄方面有一定的价值。X线平片、CT、MRI在椎体滑脱程度、部位上具有较好的一致性,在类型判定上CT明显优于X线平片和MRI。结论:影像学检查在腰椎小关节退变损伤的诊断上各有其优缺点,应结合临床症状及体征合理选择检查方法,为临床诊断提供准确的影像信息和最佳的治疗方案。

     

    Abstract: Objective: Improved imaging in lumbar facet joint degeneration in clinical understanding.Materials and methods: Retrospective analysis of 80 cases of degenerative lumbar facet joint injury in patients with X-ray,CT,MRI imaging data,in the facet joint bone,proliferation and articular surface flatness,joint space(narrowing,vacuum sign),joint dislocation,facet fracture,yellow ligament calcification,articular cartilage,joint capsule swelling,synovial cyst,synovial cyst hernia in terms of three other shows to compare;and degenerative injuries caused by lumbar spondylolisthesis,the degree in the slip,location,type,diagnosis and surgery on three findings.Results: The result showed that CT displayed more clearly on the sclerotin of small joint axon,articular surface hyperplasia and smoothness,joint space,joint dislocation,joint nonunited fractures and yellow ligament calcification than X-ray and MRI,but MRI play ed a more important role in articular surface cartilage and joint capsule swelling,cyst synovial as well as synovial hernial sac.Besides,X-ray also helped to the articular surface hyperplasia and Joint space narrowed.When it comes to the lumbar spondylolisthesis degrees and positions,the three inspection methods made no differences.Also,CT had an obvious advantage than X-ray and MRI in judging the lumbar spondylolisthesis type accurately while.Conclusion: imaging each have theirown advantages and disadvantages in image diagnosis of lumbar smalljoint degenerative damage.So,we could choose a reasonable examination method by combining with clinical symptoms and signs,offering accurate image information for clinical diagnosis and one of the best treatment plans.

     

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