Spine vertebral scan

A flat vertebral body scan is the best way to show bone fragments and their position within the spinal canal. The CT examination of the spine is routinely taken in the supine position, first positioned, the scanning plane is calibrated and the tilt angle of the gantry is determined. The thickness of the scanning layer is 2 to 5 mm for the disc disease and 10 to 15 mm for the spinal lesion. When the spinal canal is suspected, a non-ionic iodine contrast agent can be injected into the dural sac and a CT scan, ie, myelography CT. Basic Information Specialist classification: growth and development check classification: CT Applicable gender: whether men and women apply fasting: not fasting Tips: Tell your doctor if you have any drug allergies and whether you have allergic diseases such as asthma and urticaria. The CT machine is equipped with an intercom, and if there is any discomfort during the examination or an abnormal situation, the doctor should be informed immediately. Normal value Normal spine CT is performed on the transverse image of the spinal CT. The vertebral canal is formed by the vertebral body, pedicle and vertebral arch. The spinal cord is in the center of the spinal canal and has a low density shadow, which is in good contrast with the surrounding structure. The ligamentum flavum is a soft tissue density attached to the inside of the vertebral arch and the articular process, and is normally 2 to 4 mm thick. The lumbar nerve root is located in the anterolateral sac of the dural sac, with a circular high-density shadow and bilateral symmetry. Lateral recess. It is funnel-shaped, with the posterior aspect of the posterior aspect of the vertebral body, the superior articular process at the back, and the pedicle inner wall on the lateral side. Its anteroposterior diameter is less than 5mm, and there are nerve roots in the crypt. The intervertebral disc is composed of the nucleus pulposus and the annulus fibrosus, and its density is lower than that of the vertebral body. The CT value is 50-110Hu. Clinical significance Abnormal results: First, the vertebral fracture line can be clearly displayed by angiography, and the irregular strip-shaped low-density foci can clearly show the integrity of the spinal canal and the complex fractures of the attachments, such as the transverse process fracture and the spinous process fracture, while clearly showing the hard The damage of the capsule (spinal cord), intervertebral disc and nerve root can more accurately show the location of the fracture piece and foreign body and the compression of the nerve root of the spinal cord. At the same time, it can observe the spinal cord contusion and edema, which is characterized by the expansion of the spinal cord shape; And intraspinal epidural hematoma, manifested as a limitation of the wall of the spinal canal or a high-density fossa surrounding the dural sac, clear boundary; intraspinal hematoma in the dural sac, manifested as a high-density fossa in the spinal cord; spinal cord The internal hematoma is characterized by a high-density area with irregular shape in the spinal cord. Second, disc disease: 1. Lumbar disc herniation (bulging of disk): CT showed that the edge of the disc is well-proportioned and diffusely bulging and beyond the vertebral bone plate. The intervertebral disc can contain gas (vacuum phenomenon), which is easily confirmed by CT. 2. Intervertebral disc prolapse: CT showed a block shadow of the intervertebral disc in the front of the spinal canal. The CT value was lower than the bone but higher than the dural sac; 2 the fat layer between the spinal canal and the dural sac disappeared, and the system first changed; 3 nerve roots are pushed and displaced; 4 dural sac is compressed and deformed. Third, spinal stenosis (stenosisofspinalcanal): Common in the neck and waist. It is divided into two categories: congenital and acquired. The former is rare, seen in diseases such as achondroplasia, mucopolysaccharide and pedicle hypertrophy. The latter is a uniform stenosis caused by soft tissue hypertrophy around the bone or (and) spinal canal. In addition to involving the central portion of the spinal canal, lateral crypts and intervertebral foramen can also be involved. Spinal stenosis can compress the spinal cord, nerve roots and vertebral arteries, causing corresponding symptoms and signs. The CT findings are: 1 the posterior margin of the vertebral body protrudes into the spinal canal; 2 the intervertebral disc degeneration and the upper joint hypertrophy are the main causes of lumbar lateral recess stenosis. The anteroposterior diameter of the lateral recess is 2mm or less, which is definitely narrow, 2~4mm is suspicious stenosis; 3 is yellow ligament or posterior longitudinal ligament hypertrophy and ossification. Ossification of the posterior longitudinal ligament is more common in the cervical spine and can severely compress the spinal cord. 4 vertebral spondylolisthesis can cause spinal stenosis, CT can be found in the vertebral isthmus or degeneration of the intervertebral disc and ligament. Fourth, spinal trauma: X-ray examination often can not fully show the extent and severity of spinal trauma, and CT can fully show the spinal fracture, fracture type, fracture piece displacement, spinal canal deformation and stenosis and spinal canal bone fragments or vertebrae Intravascular hematoma and so on. It can also judge the condition of spinal cord trauma. In this regard, myelography CT is of greater value. Patients who need to be examined for vertebral fractures. Precautions Taboo before inspection: 1. Before the examination, the CT doctor should be informed of the detailed medical history and various examination results. If you have your own saved X-ray film, magnetic resonance film and previous CT film, you need to submit it to CT doctor for reference. 2, to explain to the doctor whether there is drug allergy, whether it has asthma, urticaria and other allergic diseases. 3, remove the inspection site clothing including underwear with metal materials and various items: such as headwear, hairpins, earrings, necklaces, jade, coins, belts and keys. 4, if CT enhanced scan or children, unconscious, need to be accompanied by healthy people. 5, CT enhanced scan If you use ion contrast agent, you need to do intravenous injection of contrast agent iodine allergy test, no response after 20 minutes, before you can check. 6, do not take heavy metal drugs within 1 week, do not do gastrointestinal tincture examination. Patients who have been tested for expectorant need to wait for the sputum to empty; if they are eager to have a CT examination, they should be treated with a cleansing enema or oral laxative to sputum. Requirements for inspection: 1. Obey the instructions of the technicians during the inspection, keep the position and do not move, and cooperate with the examination to calmly breathe, hold your breath, do not swallow, and do not blink your eyes. 2. The CT machine is equipped with a walkie-talkie. If there is any discomfort during the examination or an abnormal situation occurs, the doctor should be informed immediately. Inspection process The CT examination of the spine is routinely taken in the supine position, first positioned, the scanning plane is calibrated and the tilt angle of the gantry is determined. The thickness of the scanning layer is 2 to 5 mm for the disc disease and 10 to 15 mm for the spinal lesion. When the spinal canal is suspected, a non-ionic iodine contrast agent can be injected into the dural sac and a CT scan, ie, myelography CT. CT flat scan: layer thickness 4cm, layer spacing 4cm, window width 1800HU, window position 600HU. Not suitable for the crowd Inappropriate population: patients with severe heart and kidney failure and patients who are allergic to contrast agents.