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颈椎管狭窄、颈椎病和椎间盘突出症。

Cervical stenosis, spondylosis, and herniated disc disease.

作者信息

Jahnke R W, Hart B L

机构信息

Lovelace Medical Center, University of New Mexico School of Medicine, Albuquerque.

出版信息

Radiol Clin North Am. 1991 Jul;29(4):777-91.

PMID:2063005
Abstract

While IntCECT is still considered by many to be the optimal modality in cervical spine imaging, it is the most invasive of the techniques considered here. MR imaging may have nearly equivalent diagnostic capability in many cases of degenerative disc and spine disease. The value of unenhanced CT essentially is limited to the demonstration of bony changes. In the evaluation of radiculopathy, either MR imaging or IvCECT is useful for the initial screening and may be the only study needed. MR imaging is the study of choice for diseases of the spinal cord. With continuing progress in MR capability, IntCECT is shifting more toward a supplemental or confirmatory role. A rigid neurodiagnostic algorithm for this common radiologic problem is not possible. Rather, each step of the diagnostic process is influenced by the individual patient. Specific patient characteristics may affect the selection of an imaging modality. Modification of routine studies, such as use of gadolinium or oblique MR imaging, may be indicated in some patients. Finally, because of the high prevalence of asymptomatic disc and spine changes, knowledge of clinical findings is essential in the accurate interpretation of anatomic findings.

摘要

虽然许多人仍认为颈椎计算机断层扫描脊髓造影(IntCECT)是颈椎成像的最佳方式,但它是本文所讨论的技术中侵入性最强的。在许多椎间盘退变和脊柱疾病病例中,磁共振成像(MR成像)可能具有几乎同等的诊断能力。平扫CT的价值基本上仅限于显示骨质改变。在神经根病的评估中,MR成像或静脉内对比增强CT(IvCECT)对初始筛查均有用,且可能是唯一需要的检查。MR成像是脊髓疾病的首选检查方法。随着MR技术的不断进步,IntCECT正更多地转向辅助或确认性作用。针对这个常见的放射学问题,不可能有一个严格的神经诊断算法。相反,诊断过程的每一步都受个体患者的影响。特定的患者特征可能会影响成像方式的选择。在一些患者中,可能需要对常规检查进行调整,如使用钆剂或斜位MR成像。最后,由于无症状椎间盘和脊柱改变的高发生率,临床发现的知识对于准确解读解剖学发现至关重要。

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