腰椎间盘突出和椎管狭窄总结课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,腰椎间盘突出与椎管狭窄,北京大学第一医院CT,侯振亚,腰椎间盘突出与椎管狭窄,1,介,其椎间盘退变始于20岁,其髓核脱水,胶原纤维增生,高度减低,抗冲击力下降,纤维,环承重増加一膨岀:纤维环变脆出现裂纹;髓核碎片侵入破,裂的纤维环,髓核物质移向椎管或椎间孔。,其突出部分包括:髓核、纤维环、部分软骨终板,其软突:纤维环、髓核,箕硬突:间盘成份、韧带钙化,椎体骨质增生等,介,2,影像检查,其平片体层:筛选,了解椎体骨质,椎管狭窄,原因。,椎间隙狭窄一椎间盘退变真空变性,椎间隙前窄后宽,其脊髓造影:微侵害性,观察全面,其CT&CTM:优于单纯造影,其MRI:显示脊髓,椎间盘及周围结构,影像检查,3,影像检查,不同影像检查方法的优缺点,优点,点,脊髓造影显示硬膜囊、脊髓、神经根全貌有侵害性。潜在过敏反,椎间盘、神经根水肿,应及副作用,不能显示,观察范围广泛,硬膜囊外、梗阻上方。,其CT,无创,全面显示椎间盘及周围组织不能动态观察、相对局,包括骨性结构,限。金属伪影。,CTM造影剂用量少,需做腰穿,显示硬膜囊内脊髓或神经根,病变定位问题。,尤其适用颈椎,其MR,无创、无放射性,空间分辨率低于CT,多种层面观察,骨赘、韧带骨化显示差,直接显示椎间盘及脊髓内情况,磁场禁忌,影像检查,4,解剖,D,解剖,5,腰椎间盘突出和椎管狭窄总结课件,6,腰椎间盘突出和椎管狭窄总结课件,7,腰椎间盘突出和椎管狭窄总结课件,8,腰椎间盘突出和椎管狭窄总结课件,9,腰椎间盘突出和椎管狭窄总结课件,10,腰椎间盘突出和椎管狭窄总结课件,11,腰椎间盘突出和椎管狭窄总结课件,12,腰椎间盘突出和椎管狭窄总结课件,13,腰椎间盘突出和椎管狭窄总结课件,14,腰椎间盘突出和椎管狭窄总结课件,15,腰椎间盘突出和椎管狭窄总结课件,16,腰椎间盘突出和椎管狭窄总结课件,17,腰椎间盘突出和椎管狭窄总结课件,18,腰椎间盘突出和椎管狭窄总结课件,19,腰椎间盘突出和椎管狭窄总结课件,20,腰椎间盘突出和椎管狭窄总结课件,21,腰椎间盘突出和椎管狭窄总结课件,22,腰椎间盘突出和椎管狭窄总结课件,23,腰椎间盘突出和椎管狭窄总结课件,24,腰椎间盘突出和椎管狭窄总结课件,25,腰椎间盘突出和椎管狭窄总结课件,26,腰椎间盘突出和椎管狭窄总结课件,27,腰椎间盘突出和椎管狭窄总结课件,28,腰椎间盘突出和椎管狭窄总结课件,29,腰椎间盘突出和椎管狭窄总结课件,30,腰椎间盘突出和椎管狭窄总结课件,31,腰椎间盘突出和椎管狭窄总结课件,32,腰椎间盘突出和椎管狭窄总结课件,33,腰椎间盘突出和椎管狭窄总结课件,34,腰椎间盘突出和椎管狭窄总结课件,35,腰椎间盘突出和椎管狭窄总结课件,36,腰椎间盘突出和椎管狭窄总结课件,37,腰椎间盘突出和椎管狭窄总结课件,38,腰椎间盘突出和椎管狭窄总结课件,39,腰椎间盘突出和椎管狭窄总结课件,40,腰椎间盘突出和椎管狭窄总结课件,41,腰椎间盘突出和椎管狭窄总结课件,42,腰椎间盘突出和椎管狭窄总结课件,43,腰椎间盘突出和椎管狭窄总结课件,44,腰椎间盘突出和椎管狭窄总结课件,45,腰椎间盘突出和椎管狭窄总结课件,46,腰椎间盘突出和椎管狭窄总结课件,47,腰椎间盘突出和椎管狭窄总结课件,48,腰椎间盘突出和椎管狭窄总结课件,49,腰椎间盘突出和椎管狭窄总结课件,50,腰椎间盘突出和椎管狭窄总结课件,51,腰椎间盘突出和椎管狭窄总结课件,52,腰椎间盘突出和椎管狭窄总结课件,53,腰椎间盘突出和椎管狭窄总结课件,54,腰椎间盘突出和椎管狭窄总结课件,55,腰椎间盘突出和椎管狭窄总结课件,56,腰椎间盘突出和椎管狭窄总结课件,57,腰椎间盘突出和椎管狭窄总结课件,58,腰椎间盘突出和椎管狭窄总结课件,59,腰椎间盘突出和椎管狭窄总结课件,60,腰椎间盘突出和椎管狭窄总结课件,61,腰椎间盘突出和椎管狭窄总结课件,62,腰椎间盘突出和椎管狭窄总结课件,63,腰椎间盘突出和椎管狭窄总结课件,64,腰椎间盘突出和椎管狭窄总结课件,65,腰椎间盘突出和椎管狭窄总结课件,66,腰椎间盘突出和椎管狭窄总结课件,67,腰椎间盘突出和椎管狭窄总结课件,68,腰椎间盘突出和椎管狭窄总结课件,69,腰椎间盘突出和椎管狭窄总结课件,70,腰椎间盘突出和椎管狭窄总结课件,71,腰椎间盘突出和椎管狭窄总结课件,72,腰椎间盘突出和椎管狭窄总结课件,73,腰椎间盘突出和椎管狭窄总结课件,74,腰椎间盘突出和椎管狭窄总结课件,75,腰椎间盘突出和椎管狭窄总结课件,76,腰椎间盘突出和椎管狭窄总结课件,77,腰椎间盘突出和椎管狭窄总结课件,78,腰椎间盘突出和椎管狭窄总结课件,79,腰椎间盘突出和椎管狭窄总结课件,80,腰椎间盘突出和椎管狭窄总结课件,81,腰椎间盘突出和椎管狭窄总结课件,82,腰椎间盘突出和椎管狭窄总结课件,83,腰椎间盘突出和椎管狭窄总结课件,84,腰椎间盘突出和椎管狭窄总结课件,85,腰椎间盘突出和椎管狭窄总结课件,86,腰椎间盘突出和椎管狭窄总结课件,87,腰椎间盘突出和椎管狭窄总结课件,88,腰椎间盘突出和椎管狭窄总结课件,89,