正常国人腰段硬膜外脂肪分布及厚度

Distribution and thickness of epidural fat in lumbar vertebral canal of normal Chinese adults

目的:通过磁共振成像(MRI)探讨正常国人腰段椎管内硬膜外脂肪的分布特征、厚度及其临床应用价值。方法:在MRI正中矢状位观察263例正常国人椎管内硬膜外脂肪的形态及分布特征,测量各节段脂肪厚度并进行统计学分析。结果:腰段硬膜外脂肪在椎管周围分布不等,腹侧成条带状或新月状,背侧脂肪呈节段性梭形分布;椎管内硬膜外背侧脂肪各节段中以第3、4腰椎(L3/4)水平最厚,以第5腰椎、第1骶椎(L5/S1)节段最薄。L5/S1节段平均脂肪厚度小于L4/5节段;第12胸椎、第1腰椎(T12/L1)节段脂肪厚度小于L1/2节段,其他相邻节段脂肪平均厚度比较,差异无统计学意义。结论:正常国人腰骶段椎管内脂肪厚度的正常值范围可以为临床某些椎管疾病提供诊断及治疗依据;L5/S1节段椎管硬膜外背侧脂肪最薄,可以作为腰骶椎分界依据,为腰骶椎变异的患者提供定位依据之一。

Objective： To evaluate the clinical significance of the distribution characteristics as well as the normal range of thickness of lumbosacral canal fat in normal adults. Methods： The characteristics of morphology and distribution of lumbosacral fat in 263 normal adults were observed on mid-sagittal diameter （MSD） of MRI TlWI, then the thickness of the anterior and posterior of epidural fat was measured and analyzed. Results： Fat in the epidural space presented uneven distribution along the lumbar spinal canal. The anterior epidural fat showed a banded or crescent shape, while the posterior epidural fat had a segmental distribution with a spindle shape. Fat in the dorsal spinal epidural space was the thickest in L3/4 and the thinnest in L5/S1. Fat in the posterior of epidural space was thinner in L5/S1 than that in L4/5, and it was also thinner in T12/L1 segment than that in L1/2. However, average thickness of fat in the other adjacent segment had no significant difference Conclusion： The distribution characteristics and thickness of the lumbosaeral canale epidural fat can be referred to diagnose and treat some spinal canal diseases. The thinnest fat segment, L5/S1 segment, can be recognized as the boundary line between the lumbar and sacral segment, especially for patients with vertebral variation.