特殊类型腰骶移行椎的影像学表现

Imaging findings of the special type of lumbosacral transitional vertebrae

目的探讨特殊类型腰骶移行椎(LSTV)的影像学表现,提高对本病的认识。方法回顾性分析10例特殊类型腰骶移行椎的所有临床和影像资料。结果10例中,骶椎腰化8例,腰椎骶化2例。所有10例双侧横突均未见肥大,高度均<19 mm,双侧横突-骶骨翼均未形成假关节或骨性融合。2例腰椎骶化表现为腰-骶椎体间骨性融合,椎间隙部分或完全消失。4例骶椎腰化磁共振(MR)均可见发育成熟的S1~2椎间盘;表现为移行椎间盘突出2例,上位椎间盘突出4例;移行椎间盘pfirrmann 2级2例,3级1例,4级1例(伴纤维环断裂、终板Modic改变),上位椎间盘pfirrmann 2级1例,3级2例,4级1例。结论特殊类型LSTV表现为横突未见肥大,且可见到“第6腰椎”或腰-骶椎体间的骨性融合,MRI可见到发育成熟的S1-2椎间盘或完全塌陷的L5~S1椎间盘。

Objective To investigate the imaging manifestations of the special lumbosacral transitional vertebrae and to improve the understanding of this disease.Methods All clinical and imaging data of 10 cases with special lumbosacral transitional vertebrae were analyzed retrospectively.Results Among the 10 cases,8 cases were lumbarization and 2 cases were sacralization.No bilateral dysplastic transverse processes with height>19 mm were observed in all the 10 cases.There was no pseudarthrosis or osseous fusion of the transverse processes and sacrum wings on both sides.2 cases with sacroalization presented lumbarosacral intervertebral bone fusion,with partial or complete disappearance of the intervertebral space.Mature S1-2 intervertebral discs were observed on magnetic resonance images of 4 cases with lumbarization.The results were as follows:2 cases with transitional intervertebral discs herniation,4 cases with the adjacent cephalad segments herniation.There were 2 cases with pfirrmann grade 2,1 case with Grade 3,1 case with pfirrmann grade 4(with annular tear and Modic change)on transitional intervertebral discs,There were 1 case with pfirrmann grade 2,2 cases with pfirrmann grade 3,and 1 case with pfirrmann grade 4 on the adjacent cephalad segments.Conclusion The special type of LSTV showed no hypertrophy of transverse processes,and the"sixth lumbar vertebra"or lumbarosacral intervertebral bone fusion was observed.Mature S1~2 intervertebral discs or completely collapsed L5~S1 intervertebral discs were observed on MRI.