目的 探讨第5腰神经(L5)病变高分辨率CT(high-resolution computed tomography, HRCT)重建同层显示的可行性,为该神经病变的临床诊断提供依据。方法 筛选 20例(40侧)正常及30例(41侧)病变者的L5神经。使用美国GE公司Light Speed 16层和PHILIPS iCT 256层螺旋CT扫描,然后传至工作站(GE,ADW4.1及Philips Brilliance 3.0)进行多平面重建,观察L5神经正常解剖及病变基本表现。结果 正常L5神经在斜冠状面上呈双侧对称的弧形条索状,整体形态呈“八字形”,由硬膜囊穿出至椎管外腰大肌缘20例(100%);16例(80%)显示至骶髂关节上段。斜冠状内旋切面上20例(100%)显示起点至骶髂关节平面处;6例(30%)至骶丛神经或坐骨神经上段。显示L5神经病变处走行方向及张力状态改变16例(24侧),模糊15例(18侧),受压及萎缩12例(18侧),局部增粗3例(5侧),扭曲变形1例(1侧)。其中导致神经病变L5~S1椎间盘侧方突出伴骨质增生10例(15侧),L5横突肥大5例(8侧),L5峡部裂8例(10侧),L5压缩骨折3例(4侧),腰骶段恶性肿瘤4例(4侧)。结论 HRCT重建同层显示技术能够清晰显示L5神经解剖及相关疾病,对该神经疾病可提供有价值的诊断信息。
Abstract
Objective To explore the feasibility of CT on multiple plane reconstruction of the lesion 5th lumber nerve at the same slice, providing the basis for the clinical diagnosis of L5 neuropathy. Methods 30 patients with of L5 neuropathy and 20 normal adults were scanned by GE Light Speed 16 and PHILIPS iCT 256-slice CT, reconstructed with their own workstations (GE, ADW4.1 and Philips Brilliance 3.0) to observe the normal anatomy and basic disease of L5 nerve. Results 20 cases (40 sides)of normal L5 nerve were symmetrically displayed from starting point to margin of psoas major and 15 cases (75%) to upper sacroiliac joint in oblique coronal plane. 20 cases (100%)of L5 nerve were displayed from starting to sacroiliac joint plane and 6 cases (30%) were shown to sacral plexus or upper sciatic nerve by internally rotating oblique coronal plane. In all of the L5 neuropathy, there were travel direction and tension status change in 16 cases(24 sides), shrink in 12 cases(18 sides), localized thickening 3 cases(5 sides), fuzzy 15 cases(18 sides) and distorted in 1 case(1 side). L5 neuropathy involved L5-S1 disc lateral protrusion with bone hyperplasia (10 cases), hypertrophy of transverse process of 5th lumbar vertebra (5 cases), L5 spondylolysis (8 cases), L5 vertebral compression fracture (3 cases) and pelvic malignancies(4 cases). Conclusions HRCT multiple plane reconstruction technique at the same slice can provide a valuable diagnosis basis for L5 neuropathy.
关键词
腰5神经 /
计算机断层成像 /
多平面重建
Key words
the 5th lumber nerve /
computed tomography /
multiple-plane reconstruction
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