Harvey C J, Richenberg J L, Saifuddin A, Wolman R L
Department of Radiology, The Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK.
Clin Radiol. 1998 Oct;53(10):723-8. doi: 10.1016/s0009-9260(98)80313-9.
Lumbar spondylolysis represents a stress fracture of the pars interarticularis and occurs most commonly at the L5 level. Pars defects can be imaged with plain radiography, bone scintigraphy, computed tomography (CT) and magnetic resonance imaging (MRI). Plain radiographic projections of particular value include the coned lateral view of the lumbosacral junction, which displays the majority of defects, and the anteroposterior view with 30 degrees cranial angulation. The value of oblique radiography is unproven. Planar bone scintigraphy (PBS) is more sensitive than radiography and single photon emission computed tomography (SPECT) more sensitive and specific than PBS. Both these techniques, however, are less specific than radiography and CT. CT, when performed with a reverse gantry angle and thin sections, is the investigation of choice for identifying radiographically occult lyses. Conventional lumbar spine MRI techniques are valuable for demonstrating normality of the pars, but may be associated with a high false positive rate for the diagnosis of pars defects.
腰椎峡部裂是关节突间部的应力性骨折，最常发生于L5水平。峡部缺损可通过X线平片、骨闪烁显像、计算机断层扫描（CT）和磁共振成像（MRI）进行成像。具有特殊价值的X线平片投照包括腰骶关节的锥形侧位片，可显示大多数缺损，以及30°头侧成角的前后位片。斜位X线摄影的价值尚未得到证实。平面骨闪烁显像（PBS）比X线平片更敏感，单光子发射计算机断层扫描（SPECT）比PBS更敏感且更具特异性。然而，这两种技术的特异性均低于X线平片和CT。当以反向机架角度和薄层进行CT检查时，是识别X线隐匿性峡部裂的首选检查方法。传统的腰椎MRI技术对于显示峡部的正常情况很有价值，但对于峡部缺损的诊断可能有较高的假阳性率。
