超声评估腰椎关节突关节的可行性研究

摘要

目的 对比正常与退变腰椎小关节的超声与CT测值,评价采用超声评估腰椎小关节的可行性.方法 选取2014年1月至2015年12月在中国医科大学附属盛京医院进行检查慢性腰痛患者15例,作为慢性腰痛患者组,选取本院体检中心健康志愿者19人作为健康对照组.分别测量正常与异常腰椎L1-S1各个小关节的超声与CT测值(长度与宽度),对健康对照组L1-S1各个小关节左右侧超声测量长度与宽度,健康对照组与慢性腰痛患者组的超声测值、超声与CT测值进行t检验.结果 超声能够清晰地显示异常的小关节病变,表现为关节边缘骨质增生,关节下骨质破坏,关节软骨磨损或病变而变薄或增厚.对于腰椎小关节的长度与宽度,正常与异常腰椎小关节的超声测量值之间均值长度的比较,差异有统计学意义[(1.26±0.03) cm vs(1.43±0.05) cm,t=2.626,P＜0.05];均值宽度的比较,差异有统计学意义[(0.18±0.01) cm vs (0.15±0.02) cm,t=2.264,P＜0.05].患者组15例,共150个小关节,超声与CT 2种检查方法所得测值之间均值长度比较,差异无统计学意义[(1.43±0.17) cm vs (1.42±0.16) cm,t=1.655,P＞0.05],宽度比较,差异无统计学意义[(0.15±0.03) cm vs (0.14±0.03) cm,t=1.656,P＞0.05].结论 超声可清晰显示腰椎小关节的结构,对于腰椎小关节退变的诊断具有一定意义.%Objective To assess the feasibility and accuracy of ultrasound evaluation of facet joint in the lumbar spine by comparison of ultrasonography and CT measurements in normal and degenerative lumbar vertebra small joint.Methods Fifteen patients with chronic low back pain in Shengjing hospital of China Medical University were taken as the study group,and 20 healthy volunteers as the healthy controls from physical examination center of our hospital between January 2014 and December 2014.The ultrasonic and CT values were measured in L 1-S 1 small joints between normal and abnormal lumbar joints (height and width).The length and width of the left and right side small joints of healthy controls,ultrasonic measurement of healthy controls and patients with chronic low back pain,and value of ultrasonography and CT measurements were compared by using t test.Results The abnormal facet joint can be clearly showed by sonography,characterized by bone hyperplasia of edge joints,bone destruction,wear or thinning/thickening of articular cartilage.For the length and width of the lumber joints,the difference of ultrasonic measurement values between normal and abnormal lumbar joints were statistically significant [(1.26±0.03) cm vs (1.43±0.05) cm,t=2.626,P ＜ 0.05;(0.18±0.01) cm vs (0.15±0.02) cm,t=2.264,P ＜ 0.05].In patient group,the difference of length and width values in a total of 150 small joints between ultrasonography and CT were not statistically significant [(1.43 ± 0.17) cm vs (1.42 ± 0.16) cm],t=1.655,P ＞ 0.05;(0.15 ± 0.03) cm vs (0.14±0.03) cm,t=1.656,P ＞ 0.05].Conclusions The facet joint of the lumbar can be clearly shown by sonography and it is valuable in the diagnosis of small joint degeneration for lumbar vertebra.