基于腰椎平片的解剖标志对腰骶椎节段判定的价值  

Value of anatomic landmarks of lumbar plain film in correct numbering of lumbosacral vertebrae

作　　者：章云 陈松 吴丽 曾旭文 熊玉超 刘雅慧 ZHANG Yun;CHEN Song;WU Li;ZENG Xu-wen;XIONG Yu-chao;LIU Ya-hui(Department of Radiology,Guangzhou Red Cross Hospital,Jirum University,Guangzhou 510220,Guangdong,China)

机构地区：[1]广州市红十字会医院,暨南大学附属广州红十字会医院放射科,广东广州510220

出　　处：《生物医学工程与临床》2022年第1期45-49,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨腰椎平片中容易识别的解剖标志在腰椎节段编号的价值。方法选择2013年1月至2021年1月在广州市红十字会医院进行腰椎平片的患者1 555例,其中男性845例,女性710例;年龄15~88岁,平均年龄64.65岁。全部患者均能利用椎体计数金标准对椎体进行编号,包括脊椎X射线或者椎体MRI检查;以椎体计数金标准为依据,比较第12肋骨定位法、腰大肌起点定位法和腰3横突定位法在腰椎节段编号的准确度。结果腰椎骶化患者234例,骶椎腰化患者158例,非腰骶化患者1 163例。腰大肌起点定位法、第12肋骨定位法和腰3横突定位法在腰椎编号的准确度比较,差异有统计学意义(χ^(2)=969.05,P=0.00)。在所有患者中,第12肋骨定位法准确度最高(95.76%);在腰椎骶化患者中,腰大肌起点定位法准确度最高(93.16%);在骶椎腰化患者中,第12肋骨定位法准确度最高(83.54%);在非腰骶化患者中,第12肋骨定位法准确度最高(98.19%)。结论第12肋骨定位法是相对可靠的腰椎编号标志,但应仔细区分腰1椎体过长的横突和发育不良的第12肋骨,在区分困难时,可利用腰大肌起点定位法对腰椎进行编号。Objective To explore the value of easily recognizable anatomical landmarks in lumbar spine segment numbering in plain lumbar spine radiographs. Methods From January 2013 to January 2021, 1 555 lumbar plain radiographs patients were enrolled, which included 845 males and 710 females, aged 15-88 years old with mean age of 64.65 years old. The vertebral body count gold standard was used to number vertebral body for spine X-ray or vertebral body MRI examination. The vertebral body count gold standard was used as basis, and numbering accuracy was compared in the 12 th rib positioning method, psoas major origin positioning method and vertebral transverse process positioning method in lumbar spine segment.Results There were 234 cases of lumbar sacralization, 158 of sacral lumbarization, and 1 163 of non-lumbosacralization. The numbering accuracy of 3 positioning methods in lumbar spine was statistically significant(χ^(2)= 969.05, P = 0.00) in all patients,the 12 th rib positioning method showed the highest accuracy(95.76 %);in patients with lumbar sacralization, the psoas major origin positioning method showed the highest accuracy(93.16 %);in patients with sacral lumbar spine, the 12 th rib positioning method showed the highest accuracy(83.54 %);in patients with non-lumbosacralization, the 12 th rib positioning method showed the highest accuracy(98.19 %). Conclusion It is demonstrated that the 12 th rib positioning method is relatively reliable in lumbar spine numbering, but the excessively long transverse process of the lumbar 1 vertebrae and dysplastic 12 th rib should be carefully distinguished, and psoas major origin positioning method could be used in necessary.

关 键 词：腰骶部 腰椎平片 移行椎 节段定位 腰大肌起点定位法 第12肋骨定位法 腰3横突定位法 

分 类 号：R816.8[医药卫生—放射医学] R681.58[医药卫生—临床医学]