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目的总结多层螺旋CT在诊断脊髓分裂畸形中的临床应用。方法 13例脊髓分裂畸形的病人均进行全脊椎CT扫描,后分别进行图像后处理,方法包括多平面重组(MPR)、容积再现(VR)、最大密度投影(MIP)、曲面重组(CPR),比较各种图像后处理方法在判断椎管内骨嵴的形态、范围、伴发椎体畸形以及相应脊髓改变等方面的各自优势。结果 13例病人中PangⅠ型8例(61.5%),PangⅡ型5例(31.5%)。VR像对于6例椎管内骨性分隔及伴发椎体畸形的形态显示较好,立体感强;但2例纤维性分隔及所有病人脊髓的改变几乎不能显示。MIP对骨骼和脊髓的异常均能显示,但4例脊椎侧弯的病例难以显示脊椎全貌。CPR像对4例脊柱侧弯的病人可显示脊椎全貌,但脊髓改变在2例侧弯程度较重的病人中难以清晰显示。结论 CT诊断脊髓分裂畸形准确、可靠,多种图像后处理方法结合使用可最大限度的对病变节段的椎体、脊髓状况做出判断,有利于临床治疗方案的确定。
Objective To summarize the clinical application of multislice spiral CT in the diagnosis of spinal deformity. Methods Thirteen patients with spinal cord deformity underwent whole-spine CT scan and post-treatment respectively. The methods included MPR, VR, MIP, CPR, Comparison of various image post-processing methods in determining the shape and extent of spinal canal bone ridge, accompanied by vertebral deformity and the corresponding changes in spinal cord and other aspects of their respective advantages. Results Among the 13 cases, 8 cases (61.5%) had PangⅠtype and 5 cases (31.5%) had Pang Ⅱ type. The VR images showed a good stereopsis for the morphology of 6 cases of spinal canal separation and concomitant vertebral deformity. However, the change of spinal cord in 2 cases with fibrous septum and in all patients showed almost no signs. MIP bone and spinal cord abnormalities can be displayed, but 4 cases of scoliosis difficult to show the whole picture of the spine. The CPR image showed a complete picture of the spine in 4 patients with scoliosis, but spinal cord changes were difficult to clearly show in 2 patients with a high degree of scoliosis. Conclusion CT diagnosis of spinal dehiscence is accurate and reliable. Combined with a variety of image post-processing methods, CT can determine the vertebral body and spinal cord of the lesion to the maximum extent, which is in favor of the determination of clinical treatment plan.