Abstract
目的 探讨腰神经根(LNR)16层螺旋CT多平面重组同层显示的解剖学特征及临床价值.方法 选55例腰椎正常者和23例经手术病理证实的LNR病变者(腰椎椎间盘突出症8例、椎管狭窄症5例、恶性肿瘤4例、创伤5例及结核1例).使用美国GE公司生产的Light Speed 16层螺旋CT扫描,在工作站(ADW 4.1)上利用UNIX操作系统进行LNR多平面重组,选取LNR走行清晰的同层显示层面,观察其解剖学特征.对病变者重点分析其异常表现.结果 在斜冠状面上双侧LNR可对称显示:55例(100%)L1～5的LNR均可分别单节段显示;55例(100%)L1～2或L2～3,以及L3～4的LNR均可同时显示2个节段;49例(88%)L1～3、46例(84%)L2～4、20例(36%)L3～5可同时显示3个节段;15例(27%)L1～4的LNR同时显示4个节段;8例(15%)同时显示5个节段LNR.每条LNR均能显示走行的起止点、方向、大小、形态、张力状态及毗邻关系.除斜冠状面外LNR均不能对称显示,但显示的长度相对增加而数目减少,单根重组时LNR均显示的最长.LNR异常主要表现受压23例,同时伴粘连20例,移位14例,萎缩13例,增粗9例.结论 16层螺旋CT的多平面重组同层显示技术是整体显示LNR解剖学特征极为理想的方法,它对LNR病变的影像学诊断奠定了基础.LNR走行同层显示及路标的新概念,可能为其进一步影像学研究奠定基础。
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