【作者】 曲扬；

【导师】 赵宝林； 朱庆三； 崔树森； 孙辉；

【作者基本信息】 吉林大学 ， 临床医学， 2008， 硕士

【摘要】 目的通过椎管造影检查对不同腰椎管狭窄症定位诊断和手术方法选择中的作用的探讨,明确其作为腰椎管狭窄症检查方法的价值及必要性。方法对我院2003年9月～2007年5月已行腰椎管造影检查的腰椎管狭窄症患者42例进行回顾性分析,比较椎管造影较其他影象学检查在定位诊断方面的优势,明确其价值。结果7例患者可通过腰椎管造影检查解释临床症状与CT和MRI检查结果不相符情况;11例患者在CT及/或MRI检查定位不明确时通过腰椎管造影检查能够明确定位;20例患者可于多节段腰椎管狭窄确定责任节段。4例患者仍需行间盘、神经根造影检查明确诊断。全部病例经手术证实诊断并解释症状及体征。结论腰椎管狭窄症患者的诊断中,临床症状、体征与CT、MRI等检查结果不相符或CT、MRI无法准确定位时椎管造影检查可作为有效的诊断方法明确定位,特别在多节段腰椎狭窄责任节段的确定,便于医生选择手术减压的范围及部位,从而简化术式,减少或避免了医源性腰椎不稳的发生,节约了医疗成本,明显缩短了病人康复的时间。因此椎管造影对腰椎管狭窄症的定位诊断及手术方式选择有重要价值,应给予足够的重视和重新评估。更多还原

【Abstract】 Objective: To study the effect of Lumber Spinal Stenosis’s location and therapy decision by spinal angiography, making clear it’s value and necessity as one important method of the Lumber Spinal Stenosis’s diagnosis.Methods: From September 2003 to May 2007, We retrospectively reviewed the 42 cases of Spinal Stenosis dianogsed by spinal angiography. To find the advantage in location of Spinal Stenosis, spinal angiography was compared with other imaging methods.Results: 7 cases whose clinical symptoms are different from the results of CT and MRI, but can be diagnosed by spinal angiography. 11 cases were definitely located by spinal angiography but not CT and MRI. 20 cases were decided responsibility segmental in muti-level lumber Spinal Stenosis. 4 cases still need to be further diagnosed by spinal nerve root myelography. All the cases’diagnosises and clinical symptoms have been confirmed by surgery.Conclusion: When diagnosing Spinal Stenosis, CT and MRI are not suitable to all cases, spinal angiography is a good choice in the diagnosis of Spinal Stenosis, especially when facing cases of muti-level lumber Spinal Stenosis. When operators need to reduce pressure and the disadvantage during surgery, spinal angiography is a good measurement for doctors to understand the scope and location conveniently. All these come together to show that spinal angiography is of great value in location and therapy plan decision of Spinal Stenosis.更多还原