正常人脊髓圆锥位置和马尾神经的MRI研究  

MR Imaging Study of the Conus Medullaris Tip Position Variation and the Spinal Nerves of Cauda Equina in the Normal Adults

作　　者：邓先波[1] 孔祥泉[1] 刘定西[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2007年第6期548-551,共4页Journal of Clinical Radiology

摘　　要：目的通过MRI研究正常人脊髓圆锥位置的变化和马尾神经形态,探讨三维稳态构成干扰序列(3DCISS)马尾神经成像技术及应用价值。资料与方法应用1.5T磁共振成像系统对20名正常成人进行腰骶椎MR检查,自旋回波T1WI、正中矢状面像上观察脊髓圆锥的位置,并根据相应椎体的上、中、下1/3及椎间盘的对应关系定位。应用T2WI3DCISS序列行骶骨容积扫描,采用多平面重组(MPR)后处理,观察3DCISS序列对马尾神经的显示。结果20名成人脊髓圆锥下端位置多在L1椎体平面(15名,75%);在通过骶孔的MPR平面上,脊神经的前根位于后根的前内侧;后根较相应节段的前根粗大;在平行于骶管的MPR平面上,可显示S1～5脊神经以及终丝;终丝居中,两侧脊神经对称分布,从内到外依次为S5、S4、S3、S2、S1脊神经。结论MRI可以观测到脊髓圆锥下端的位置,能帮助临床诊断脊髓栓系综合征;3DCISSMPR可以清晰地显示脊神经的走行以及脊神经前、后根的排列,对手术治疗中脊神经的选择和脊神经前、后根的鉴别有重要的参考价值。Objective To investigate the variation in position of the conus medullaris by MR imaging, and evaluate the technical and clinical application of MRI of cauda equine spinal nerves medality using 3D CISS sequence. Materials and Methods Spin echo T1 WI sagittal scanning of lumbosacral spine was performed in 20 normal adults to identify the tip of the conus medullaris by using 1.5T MR machine. The position of the lower end of the conus medullaris was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body and the adjacent intervertebral disc, and the results were statistically analyzed. Volume scanning of lumbosacral was performed in 20 normal adults using 3D CISS sequence. Post-procession with multiple plane reconstruction （MPR） was operated to evaluate the ability of 3D CISS sequence to show anatomic structures of cauda equine spinal nerves. Results In most cases, the position of conus medullaris was at the level of L1 vertebral （ 15/20, 75% ）, range from disc of TH12 - L1 to the upper third of L2. No significant difference in the position levels was found between different sex （P 〉0. 05）. In the plane of MPR through the sacral foramina, the anterior root located anterlor-medial of posterior root, and the width of posterior root was larger than that of equivalent anterior root. S（1-5） spinal nerves and the ilium terminale could be precisely showed in the plane parallel to the sacral duct. Filum terminale located in the center, spinal nerves were distributed zygomorphic. From the inner to the outer, were S5、S4、S3、S2、S1 spinal nerves in turn. Conclusion MRI can show the variation of conus medullafis location, and it is very useful in diagnosing tethered cord syndrome; 3D CISS sequence could clearly show structure and distribution of cauda equine spinal nerves. MRI is of significant importance for the choice of proper spinal nerves and the identification of anterior or posterior spinal roots to the operation in lumbosacral vertebral canal.

关 键 词：磁共振成像 稳态构成干扰序列 脊髓圆锥 马尾神经 

分 类 号：R445.2[医药卫生—影像医学与核医学]