超声探测腰椎小关节的可行性和准确性研究

Feasibility and Accuracy of Ultrasound-guided Methodology in the Examination of Lumbar Spine Facet Joints

目的探讨临床上超声探测腰椎小关节的可行性和准确性,为超声引导腰椎小关节阻滞提供技术支持。方法选择符合纳入和排除标准的健康志愿者10例,用PHILIP HDI 5000型超声仪对腰椎L1～S1的小关节(上下关节突关节)进行横断面扫描,在超声横截面图像上,经该平面的棘突中点作一直线与该平面的下关节突呈切线相交,交点作为参考点(即该平面的下关节突的最外缘),测量棘突中点到参考点的水平距离(a)、垂直距离(b)和棘突中点到参考点的距离(c),并在志愿者背部皮肤上做好标记,再用CT扫描标记好的平面,用CT测量工具测量上述距离,比较两组对应距离的差异。结果超声准确探测到88个腰椎小关节,成功率达88%(88/100);各节段左右两边小关节的a、b和c的超声测量值与相对应的CT测量值比较,差异无统计学意义(P>0.05)。结论超声可用于探测腰椎小关节,且准确性较高。

Objective To investigate the feasibility,accuracy of B ultrasound in the examination of joint space of lumbar spine facet joints compared with CT scan. Methods Ten healthy adult volunteers were enrolled. The joint space of lumbar facet joints was measured by ultrasound. To identify the spinal levels, the posterior parasagittal sonograms were obtained at levels L1 to $1. The lumbar facet joints were delineated with the help of transverse sonograms at each level. Meanwhile, the lumbar facet joints were evaluated by spiral CT on the same plane, reformatted to 1-mm axial slices. Results A total of 88 lumbar facet joints from L1 to S1 were clearly visualized in the 10 volunteers. Both ultrasound and CT measurements showed the same average depth and lateral distance of lumbar facet joint space （P 〉 0. 05）. Conclusion The lumbar facet joint space can be accurately demonstrated by ultrasound.