CT三维重建在胸椎间孔穿刺定位中的应用

Application of CT 3-dimensional reconstructive images in localization of thoracic intervertebral foramen

目的采用CT三维重建定位观察胸椎间孔,以确定胸椎间孔在椎板外侧的穿刺位置以及穿刺的深度。方法选取30例非胸椎病患者的CT三维重建胸椎图像,测量椎间孔所在水平面到上位胸椎棘突中点水平面之间距离、椎间孔外口到正中线距离以及椎间孔到棘突尖距离、椎间孔前后径和上下径。结果①T1-3椎间孔到各自上一椎体棘突中点平面为(20.5±3.0)mm,T4-6为(5.1±4.7)mm,T7-9为(4.4±2.0)mm,T10-12为(19.6±5.4)mm。②在T7处,椎间孔至正中线和棘突尖的距离最近,分别(15.2±4.8)mm和(44.3±5.9)mm,向上或向下逐渐增加。③椎间孔前后径为(9.8±1.4)mm。④椎间孔上下径(12.1±3.5)mm。结论胸椎间孔可以经上位棘突准确定位。

Objective To determine puncturing localization and depth of the thoracic intervertebral foramen with 3-dimensional position in CT 3-dimensional（3DCT）reconstruction images.Methods Thirty patients with normal thoracic spines underwent 3DCT reconstruction.The width and height of intervertebral foramen,the distances between the thoracic intervertebral foramen and horizontal plane which the spinous process of the cephalad thoracic vertebra in,and the median sagittal plane,and all spinous process tip plane were measured.Results ①The vertical distance between the intervertebral foramen and the horizontal plane passing through the spinous process tip of the cephalad thoracic vertebra of T1-3,T4-6,T7-9,T10-12 were（20.5±3.0） mm,（5.1±4.7） mm,（4.4±2.0） mm and（19.6±5.4） mm,respectively.②Among all the intervertebral foramen,T7 was the nearest one to the spinous process tip and median sagittal plane,and the distance was（15.2±4.8） mm and（44.3±5.9） mm,respectively.Distances between other thoracic vertebras showed an increasing tendency.③The average width of intervertebral foramen was（9.8±1.4） mm.④ From T1 to T12,the height of intervertebral foramen increase gradually,the average was（12.1±3.5） mm.Conclusion The accurate localization of thoracic intervertebral foramen can be determined according to the cephalad spinous process tip.