正常腰神经根磁共振神经成像临床影像学特点研究

Clinical imaging characteristics of magnetic resonance neurography of normal lumbar nerve root

目的采用磁共振神经成像(magnetic resonance neuroimaging,MRN)技术测量正常成人腰神经根与周围毗邻结构的影像解剖学参数,为临床经椎间孔入路术式提供重要的解剖学参考。方法选取30名正常成年人,其中男性15名,女性15名,年龄(24.3±2.1)岁。通过薄层连续腰骶部磁共振扫描,序列为FATSAT脂肪抑制,分别测量如下参数:神经根发出点位置,神经节至椎弓根的距离,神经节大小,Kambin三角边长及面积。结果30名健康成人L1~L5神经根通过薄层MRN扫描技术均获得良好显示,双侧各节段参数差异无统计学意义。随腰椎节段下移,L1至L5神经节的长径为(6.34±0.47)^(11.25±1.52)mm,短径为(4.93±0.36)^(6.19±0.62)mm;神经节距上位椎体椎弓根下缘的距离为(7.91±1.94)^(-3.13±2.54)mm,距下位椎体椎弓根上缘的距离为(9.41±1.87)^(7.14±1.79)mm;L1~L5神经根自硬膜囊发出点距椎体下缘的距离为(8.89±2.89)^(19.96±3.70)mm,神经根腋部距神经节的距离为(7.43±2.34)^(12.98±3.31)mm;L1至L5神经根与矢状面的夹角为(39.53±3.97)°^(27.56±4.45)°;Kambin安全三角面积为(153.73±37.34)^(193.19±36.15)mm 2。结论随腰椎节段向尾端移动,神经根发出的位置逐渐升高,神经根移行为神经节的距离及神经节的面积逐渐增大;神经节距下位椎体椎弓根的距离以及神经根与硬膜囊的夹角逐渐减小;Kambin三角面积逐渐增大。以上参数可为经椎间孔入路术式提供重要解剖学参考。

Objective Magnetic resonance neuroimaging(MRN)was used to measure the imaging anatomical parameters of normal adult lumbar nerve roots and adjacent structures,providing an important anatomical reference for clinical transforaminal approach.Methods Thirty healthy adults were chosen(15 males and 15 females,aged 24.3±2.1 years old).Through a thin layer continuous lumbosacral magnetic resonance scan(the sequence was FATSAT fat suppression),the following parameters were measured:the position of origin of the nerve root,the distance from the ganglion to the pedicle,the size of the ganglion,the length and area of the Kambin triangle.Results The L1-L5 nerve roots of these 30 healthy adults were well displayed by thin-layer MRN scanning technique,and there was no difference in the parameters of the two sides.With the lumbar segment moving down,the longest diameter of the L1-L5 ganglion was(6.34±0.47)mm to(11.25±1.52)mm,and the shortest diameter was(4.93±0.36)mm to(6.19±0.62)mm.The distance between the ganglion and the lower edge of the upper vertebral pedicle was(7.91±1.94)mm to(-3.13±2.54)mm,and the distance between the ganglion and the upper edge of the lower vertebral pedicle was(9.41±1.87)mm to(7.14±1.79)mm.The distance from the L1-L5 nerve root from the dural sac to the lower edge of the vertebral body was(8.89±2.89)mm to(19.96±3.70)mm,and the distance from the origin of the nerve root to the ganglion was(7.43±2.34)mm to(12.98±3.31)mm.The angle between the nerve root and sagittal plane of the L1-L5 was(39.53±3.97)°to(27.56±4.45)°.The area of safety triangle of Kambin was(153.73±37.34)mm 2 to(193.19±36.15)mm 2.Conclusion As the lumbar segment moves toward the tail end,the position of the origin of the nerve roots gradually increases,moreover,the distance between the nerve root and the ganglion and the area of the ganglion gradually increases.0x09The distance between the ganglion and the vertebral pedicle of the lower vertebral body gradually decreases.Besides,the angle between the nerve root and the dural sac decreases gradually.The area of the Kambin triangle gradually increases.The above parameters provide an important anatomical references for the transforaminal approach.