Danielson B I, Willén J, Gaulitz A, Niklason T, Hansson T H
Department of Radiology, Sahlgrenska University Hospital, Mölndal, Sweden.
Acta Radiol. 1998 Nov;39(6):604-11. doi: 10.3109/02841859809175484.
To evaluate the effect of compressive axial loading in imaging of the lumbar spine in patients with clinically suspected spinal stenosis.
A total of 84 patients were examined, 50 with CT (after intrathecal contrast administration) and 34 with MR. First the dural sac cross-sectional area (CSA) was determined with the patient in the supine psoas relaxed position (PRP). Then the CSA was determined during supine axial compression in slight extension (ACE), obtained with a specially designed loading device. A measurement error study was performed.
A minimum difference in CSA of 15 mm2 between PRP and ACE was found to be significant. In 40/50 (80%) of CT-examined patients and in 26/34 (76%) of MR-examined patients a significant difference in CSA was found. In 25/84 (30%) of the patients there was a significant difference at more than one level.
For an adequate evaluation of the CSA, CT or MR studies should be performed with axial loading in patients who have symptoms of lumbar spinal stenosis.
评估轴向压缩负荷对临床疑似腰椎管狭窄症患者腰椎成像的影响。
共检查了84例患者，其中50例行CT检查（鞘内注射造影剂后），34例行MR检查。首先在患者仰卧腰大肌放松体位（PRP）下测定硬膜囊横截面积（CSA）。然后在仰卧位轴向压缩并轻度伸展（ACE）过程中测定CSA，通过专门设计的加载装置实现。进行了测量误差研究。
发现PRP和ACE之间CSA的最小差异为15mm²时具有显著意义。在50例CT检查患者中的40例（80%）以及34例MR检查患者中的26例（76%）发现CSA存在显著差异。在84例患者中的25例（30%），多个节段存在显著差异。
对于有腰椎管狭窄症状的患者，为充分评估CSA，应在轴向负荷下进行CT或MR检查。
