腰椎静脉丛三维增强MR静脉成像初步研究

Detection of lumbar vertebral venous plexus with magnetic resonance venography

目的 探讨正常人腰椎静脉系统在三维增强MR静脉造影(MRV)的显示率,初步确定正常人腰椎椎管内前静脉(AIVV)的宽度范围。观察腰椎静脉系统在各种疾病情况下的表现。方法89例MR增强扫描受检者行MRV检查,其中62例为正常志愿者。分别观察不同年龄组各个腰椎节段的椎管内、外静脉显示情况。测量AIVV的宽度。观察各种疾病时椎管内、外静脉的表现。结果除L1和L2水平的左右吻合静脉外,其他各个节段41岁以上组的静脉显示率均低于40岁以下组(P<0.05)。AIVV平均宽度从L1-5逐渐增粗;年龄、性别、左右侧差异无统计学意义。AIVV全部显示的42例正常志愿者中,AIVV的平均宽度L1-L5逐渐增粗,范围在(3.9±0.6)mm-(7.9±1.2)mm;各种疾病时,AIVV可表现为正常、受压、移位或扩张。结论 三维增强MR静脉造影能满意地显示AIVV各分支及椎管外静脉的全貌,能够显示各种病变时椎静脉相应改变,对于指导临床治疗、研究椎静脉的临床意义具有潜在价值。

Objective To discuss the detectability of lumbar vertebral venous plexus with MRV and establish the width range of anterior internal vertebral vein (AIVV) in normal persons, and to analyze the manifestations of the lumbar venous system in different spinal abnormalities. Methods 3D MRV was performed in 62 volunteers and 27 patients. The width of AIW was measured in normal subjects and in the patients whose veins were all detected. MRV manifestations of 27 patients with lumbar spine abnormalities were analyzed. Results The detectability of vein was not correlated with age and the width of vein showed no significant differences regarding sex. All the veins were revealed in 42 of the 62 healthy volunteers, and the width of AIW was symmetrial between sides and showed gradual enlargement from L1 to L5, ranging from (3. 9±0. 6) mm to (7. 9±1. 2) mm. The veins showed normal, compressed, displaced, or dilated in the patients. Conclusion 3D MRV can satisfactorily demonstrate the overall picture of the vertebral venous plexus, and it has the potential ability in guiding the clinical treatment as well as in further studying the clinical significance of the spinal venous system.