磁共振成像脊髓圆锥与椎体的位置关系  

The relationship of conus medullaris and vertebral position in patients with magnetic resonance imaging

作　　者：张志刚[1] 廖小卒[1] 田野[1] 王志龙[2] 肖学红[2] 黄晓星[2] 

机构地区：[1]广东省中山市人民医院麻醉科,528403 [2]广东省中山市人民医院放射科MRI室,528403

出　　处：《临床麻醉学杂志》2012年第2期166-167,共2页Journal of Clinical Anesthesiology

摘　　要：目的通过分析成人脊髓圆锥位置分布及性别差异性,指导临床麻醉及腰椎穿刺。方法对3742例成人患者(其中男1818例,女1924例)进行下腰段脊柱磁共振(MRI)扫描,测定脊髓圆锥末端相应的脊椎位置。所得结果进行统计学处理。结果 3742例患者脊髓圆锥末端位置在L1椎体上缘796例(21.27%),L1椎体平面1918例(51.26%),L1～2椎体间隙的有672例(17.96%),L2椎体上3/4有344例(9.19%),L2椎体下缘有3例(0.08%),L2～3椎体间隙有9例(0.24%)。女性圆锥位置低于男性(P<0.05)。其中在L1椎体上缘男性高于女性(P<0.05),L1～2椎体间隙,L2椎体上3/4男性低于女性(P<0.05)。结论成人脊髓圆锥末端大部分在L1椎体水平,但仍有极少部分(0.32%)低于L2椎体下缘。成年女性的脊髓圆锥末端位置低于男性。熟悉脊髓圆锥末端位置的正常范围,对帮助临床腰椎穿刺定位、指导临床麻醉有重要意义。Objective To determine the variation in position of the conus medullaris in adult and analyze the relation this position with gender, to guide for the selection of a safe intervertebral space during spinal block and other spinal tap. Methods MR imaging of lower lumbar spine was pedormed in 3 742 healthy adults （including male 1 818, female 1 924）. The position of the lower end of the conus medullaris were recorded in relation to the adjacent vertebral body and intervertebral disc, and the results were statistically analyzed. Results The position of the conus medullaris were at the level of L1 upper vertebra 796 case （21.27%）, 1 918 case （51. 26%） were at the leave of L1 vertebral disc, 672 cases （17.96%） were at the level of the L12 disk spaee,344 cases （9.19%） were at the upper three quartes of L2, 3 cases （0. 08%） were at the lower level of Le vertebra, and 9 cases （0. 24%） were at the level of the L2-3 disk space. The position of the conus medullaris was found lower in female than in male（P〈0. 05）. At the level of 1.1 vertebra was found higher in male than in female（P〈0.05）, the L1-2 disk space, and the upper of vertebra of L2 three quartes male lower than female（P〈0. 05）. Conclusion In most cases, the position of the conus medullaris was at the level of L1 vertebra, but there was still a small of thegn lower than the L2 vertebra. Female have a lower conus medullaris position than that of male ones. It would be very useful and important to know about the position of the lower end of the conus medullaris and helpful to locating lumbar puncture site.

关 键 词：脊髓圆锥 磁共振 腰椎 

分 类 号：R445.2[医药卫生—影像医学与核医学]