椎板下棘的影像学表现(附110例分析)

Multi-slice spiral CT and MRI appearance of spina lamina vertebrae inferior(analyses of 110 cases)

目的观察椎板下棘CT、MRI的影像学表现特征,为椎板下棘的影像诊断提供解剖学依据。方法对脊椎64层MSCT扫描发现有椎板下棘的110例患者进行了CT冠状位三维重建,并测量其长度,其中51例进行了MRI扫描,观察椎板下棘的部位、形态及其与椎管、椎间管毗邻关系的影像学表现。结果椎板下棘出现于T2～L5,出现率较高段在T11、T12及L1、L5,达76.9%。侧别、性别及相邻节段间均有显著性差异(P<0.01),长度最大均值区间男性为T11、T12,女性为T11、T12和L5,最大均值均位于T12,分别为(4.67±1.2)mm和(5.02±2.11)mm。椎板下棘位置固定,形态特征鲜明,胸段及大部分上腰段的椎板下棘多为长条状,相对窄基底,位于黄韧带的外侧缘,尖端指向下方,一般只对硬膜囊形成压迫,压迫程度相对较重,对椎间管压迫较少。而下腰段的椎板下棘多为相对宽基底的锥状,尖端指向前外下方,常常超过黄韧带的范围,对硬膜囊和椎间管均可形成压迫,且对椎间管压迫相对明显。结论脊椎64层MSCT矢状位重建及冠状位三维重建能清楚显示椎板下棘的位置、大小、形态,及其与椎管、椎间管的毗邻关系,脊椎MRI扫描则能直观显示椎板下棘对硬膜囊的压迫情况。

Objective To observe the imaging appearance of spina lamina vertebrae inferior （SLVI） using 64-slice sprial CT three-demensional （3D） imaging reconstruction and MRI scan, to provide anatomical basis and to certificate for image diagnosis of SLVI. Methods One hundred and ten patients with SLVI discovered by 64-slice sprial CT scan were reconstructed three-demensionally, in whom fifty-one were subjected to MRI scan. The length was measured and the imaging appearance of the type, the position of SLVI, and SLVI＇s relationship with vertebral canal and intervertebral canal were observed. Results SLVI was found thai occurrence in vertebra T2 - L5 , T11 , T12 and L1 and L5 was higher, the occur- rence rate was up to 76.9%. We found that statistical significance occurred in two sides and sexuality, as well superor and inferior segment （ P d0.01）. Tll , T12 region was the highest for length in male, T11 , T12 and L5 region was the highest in female, while the highest value concerned in Tlz was （4.67±1.2） mm and （5.02±2.11） mm respectively. The position, type of SLVI exised a specific regularity. The thoracic vertebra and the upper lumbar vertebra SVLI showed stripe, comparative narrow base, sitting surface of ligamenta flava and the point of SLVI directing downwards. The SLVI suppressed dural sac general lightly and intervertebral canal comparative little. But under lumbar vertebra, SVLI showed wide base needle, the point of SLVI was directing front, outwards and downwards, frequently exceeding the scope of ligamenta flava. The SLVI can suppress dural sac or intervertebral canal, but suppressing intervertebral canal comparative distinctly. Conclusion The segion, size, type and suppressive condition for intervertebral canal of SLVI were displayed in 64-slice sprial CT coronal 3D and saginal imaging reconstruction. Suppressive condition for dural sac was displayed in spinal MRI scan.