经皮腰椎间盘穿刺后外侧入路的影像学观察  

Imaging observation of posterolateral approach in percutaneous lumbar discs puncture

作　　者：游箭[1,2] 邵阳[3] 李春平[3] 敬宗林[3] 杨林[3] 陈伟[4] 陆明[4] 代明德[4] 谢兵[4] 胡鸿[1,2] 钟立明[1,2] 魏欣[1,2] 

机构地区：[1]川北医学院第二临床医学院 [2]南充市中心医院医学影像科,四川南充637000 [3]川北医学院附属医院放射科,四川南充637000 [4]第三军医大学西南医院放射科,重庆400038

出　　处：《中国医学影像技术》2011年第5期1013-1016,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(30770611);四川省科技厅应用基础项目(07JY029-030)

摘　　要：目的观察经皮腰椎间盘穿刺后外侧入路的影像学特征,比较CT和MRI的价值和局限性。方法在53名受检者正常腰椎间盘的CT图像、40名受检者正常腰椎间盘的MR图像上,对经皮腰椎间盘穿刺后外侧入路的影像学特征进行观察和测量。结果获得经皮腰椎间盘穿刺后外侧入路的CT、MRI影像学特征和相关测量参数,L3-S1各层面左、右侧穿刺线与腰神经根后缘的最近距离差异无统计学意义。CT对显示穿刺线的骨性标志点上关节突优于MRI,MRI对软组织密度分辨力较CT高。结论 CT、MRI是确定经皮腰椎间盘穿刺后外侧入路的重要手段,能显示经皮腰椎间盘穿刺后外侧入路结构及其毗邻关系。穿刺前应首先选择CT检查,必要时联合MR检查可提高穿刺的准确性和安全性。Objective To observe the imaging features of posterolateral approach of percutaneous lumbar discs puncture,and to compare the value and limitation of CT with MRI.Methods The imaging features of posterolateral approach of percutaneous lumbar discs puncture were observed and measured based on CT images of 53 subjects of normal lumbar discs and MR images of 40 subjects of normal lumbar disks.Results The imaging features and related measure parameters of posterolateral approach of percutaneous lumbar discs puncture were obtained.There were no significant statistical difference between the minimum distance from left and right puncture line of all levels in L3—S1 to edge of the lumbar nerve root.CT was superior to MRI in showing the bony markers of puncture line.MRI was superior to CT in distinguishing density of soft tissue.Conclusion CT and MRI are important means to decide posterolateral approach of percutaneous lumbar disc puncture and show main structures as well as adjacent relationship in lumbar discs.Before puncture,CT examination is the first choice,and combining with MRI when necessary may improve the accuracy and safety of puncture.

关 键 词：后外侧入路 椎间盘 体层摄影术 X线计算机 磁共振成像 影像学特征 

分 类 号：R681.53[医药卫生—骨科学] R445[医药卫生—外科学]