髂腰韧带在胸腰骶移行椎CT定位诊断中的价值

Value of iliolumbar ligament in the diagnosis and CT positioning of thoracic and lumbosacral transitional vertebra

目的探讨髂腰韧带在胸腰骶移行椎CT定位诊断中的价值,以提高定位准确性和阅片效率。方法通过对1291例脊柱下胸段-腰骶区域螺旋CT三维图像,观察髂腰韧带的正常起源及位置,找出正常序列脊椎及移行椎与髂腰韧带正常起源的关系,并与腰骶部移行椎或合并腰肋时的常规定位法及金标准定位法进行比较。结果髂腰韧带正常起源于L5椎体横突,在CT横断、冠状面上均能清晰显示,位置恒定,易于分辨,不论脊椎序列正常与否,以及是否合并腰肋的存在,均不影响利用髂腰韧带对腰椎节段的正确定位。结论以髂腰韧带正常起点来定位第5腰椎,可作为对胸腰骶节段快速、准确定位的依据,方法简单易行、准确性高。

Objective To analyze value of iliolumbar ligament in the diagnosis and CT positioning of thoracic and lumbosacral transitional vertebra,so as to improve positioning accuracy and efficiency of radiograph reading. Methods By performing 3D spiral CT scan images of the thoracic segments-lumbosacral area in 1291 cases,normal origin and position of iliolumbar ligament were observed,relationship between normal sequence vertebrae and transitional vertebrae and normal origin of iliolumbar ligament was found out,then comparing with conventional positioning method and gold standard positioning method of lumbosacral transitional vertebra or lumbosacral transitional vertebra combined with lumbar rib. Results The iliolumbar ligament normally originated from L5 parapophysis,and it could be clearly displayed on either CT transverse or coronary plane. Its position was constant and could be distinguished. In addition,whether vertebrate sequence was normal of not,and whether lumbosacral transitional vertebra combined with lumbar rib or not,it showed no influence on accurate positioning of lumbar vertebra by using iliolumbar ligament. Conclusion To position the 5th lumbar vertebra from normal origin of iliolumbar ligament can be used as basis of fast and accurate positioning of thoracolumbar segment. This method can be easily operated with high accuracy.