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| 摘要 目的 观察动态造影对腰椎病手术适应症的选择。方法 用“Isovist”10ml腰穿(L2-3或L3-4间隙)注入,在X线透视下观察腰椎在纵向牵引下或前屈位时椎间盘及椎管的显影类型,并捕捉时机摄X线点片。结果 200例中造影阳性189例，阳性率94.5%；176例手术，含造影阴性13例中的6例，另7例临床表现不符，未做手术，共16例造影与术中不符。造影与手术完全符合率为91%。结论 椎管动态造影对椎管狭窄、高位脊椎病变及椎管内占位性病变等有实际诊断价值，尤其适用于不具备CT、MRI的一些基层医院，具有指导意义。 关键词 椎管 动态造影 腰椎病 The analysis of lumbar vertebra disease between results of moving-myelography in Vertebra canal and that in clinic.ZHANG Hua,et al.(Hospital of Lantai,Gansu,Lanzhou,730020 China) Abstract Objictive Throughout moving-myelography,operation applications were selected for lumbar vertebra disease.Methods 10ml Isovist was injected into the interval of L2-3 or L3-4.Types of moving-myelography about lu-mbar intervertebral disc and lumbar canal were examined in X-ray throughout longitudinal traction and anterior bent, and X-ray photography was taken in suitable opportunity.Resultin 200 cases of moving-myelography,189 cases were examined with an examined rate of 94.5%.Among them,176 operated cases included 6 cases of unexamined 13 cases.The other 7 cases didn't agree with clinical symptoms so that they were not operated.The results of 16 cases with moving-myelography didn't agree with the operation.The total rates of the moving-myelographys in agreement with the operations were 91%.Conclusion The results suggestesd that vertebral canal moving-myelography may play a important role in the treatment of lumbar vertebra disease,especially in hospitals without CT and MRI. Key words Lumbar vertebra disease;Vertebral canal;Moving-myelography 1 资料与方法 1.1 临床资料 自1999年5月～今年5月使用“Isovist”椎管动态造影200例，男167例，女33例；年龄20～50岁148例，51～70岁52例。 1.2 方法 用“Isovist”10ml L2-3或L3-4腰穿注入,X线透视下观察腰椎在纵向牵引下或前屈位时椎间盘及椎管的显影类型(如全阻断型、弧形缺损型、杯口型等)，并捕捉时机摄X片。 表1 200例椎管造影显影类型
200例中造影阳性189例,阳性率94.5%；176例手术,含造影阴性13例中的6例，另7例与临床表现不符，未做手术，共16例造影与术中不符。造影与手术完全符合率为91%。显影类型见表1，16例造影与术中所见不符见表2。 表2 16例造影与术中所见不符对照
3 讨论 |
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