摘要
目的：研究内切圆面积（internal tangential circular area，CA）在中央型腰椎管狭窄中的诊断价值。方法：对200例正常成人及183例中央型腰椎管狭窄患者行腰2．5椎管CT检查。每个椎间隙层面扫描5层，每个椎体弓根上1／3处扫描1层，均垂直于椎管，层厚层距均为3mm。在软组织窗下测量：椎间隙层面软椎管内切圆面积AIV和椎体弓根上1／3处软椎管内切圆面积AV。两组采用同样的扫描和测量方法。结果：①AIV、AV的平均值分别为（153．1±33．8）nm^2、（152．6±34．1）mm^2，正常下限分别为97．7mm^2、96．7mm^2；②AIV在不同节段间无显著性差异（P〉0．05），AV在不同节段间亦无显著性差异，且AIV与AV在同节段及不同节段间也无显著性差异（P〉0．05），故合并统计，统称腰椎管内切圆面积CA，其平均值为152．8±34．0mm^2，正常下限为97．0mm^2；③分别用MSD、CA的正常下限值，来判断经手术证实的322个狭窄平面。MSD对中央型腰椎管狭窄的符合率达83．8％，CA对中央型腰椎管狭窄符合率达94．1％，高于前者。结论：内切圆面积测量法操作简单，符合率高，可同时用于评价椎体层面及椎间隙层面，可作为CT诊断中央型腰椎管狭窄的首选方法。
Objective：To investigate the diagnostic value of internal tangential circular area （CA） in CT scan for central lumbar canal spinal stenosis. Methods： CT scanning from L2 to L5 was performed for 200 normal people and 183 patients with central spinal stenosis. There are 5 layers at every intervertebral space and 1 layer at the upper one-third of every pediele which is vertical to spine. The layer thickneas and layer interval both are 3 mm. The following measurements were conducted with soft tissue window： the internal tangential circular area of soft spinal canal at the intervertebral space （AIV） and the upper corresponding space of pediele（AV）. Results：（1） The normal value of AIV,AV were expressed by mean ± standard deviation, and respectively they were （153.1±33.8）mm^2, （152.6±34.1 ） mm^2. The lower borderline of AIV, AV were 97.7mm^2 and 96.7mm^2 respectively; （2） AIV at different levels showed no significant differences, neither did AV （ P 〉0.05）. The differences between AIV and AV weren＇t statistically significant. So AIV and AV were combined by CA, which means spinal canal area. The normal value of CA was （152.8 ± 34.0）mm^2, and the lower borderline of CA was 97.0 mm^2 ; （3） 322 surgery-confirmed spinal stenosis levels were analysed according to the lower borderline of MSD and CA. The coincidence Of MSD for central spinal stenosis 83.8% and the coincidence Of CA for central spinal stenosis was 94. 1%, which was higher than MSD. Conclusion： CA was recommended as the first selection in diagnosing central spinal stenosis because of its simple operation and high accuracy rate.
出处
《医学影像学杂志》
2008年第2期155-158,共4页
Journal of Medical Imaging
关键词
椎管狭窄
内切圆面积
正中矢状径
体层摄影术
X线计算机
人体测量术
Spinal canal stenosis
Internal tangential circular areas
Median sagittal diameter
Tomography,X-ray computed
Anthropometry
作者简介
盖青竹（1969-），男，山东省莱阳市人，本科学历，主治医师，主要从事CT、MRI影像诊断工作
