CastellviⅡa型腰骶移行椎CT征象的初步观察  

Primary observation on CT features of Castellvi Ⅱ a lumbosacral transitional vertebrae

作　　者：张联合[1] 高超 余艳凤 陈荣灿 ZHANG Lianhe;GAO Chao;YU Yanfeng;CHEN Rongcan(Department of Medical Imaging,Zhejiang Hospital of Armed Police Forces,Hangzhou 310051,China)

机构地区：[1]武警浙江总队医院医学影像科,浙江杭州310051

出　　处：《实用放射学杂志》2022年第11期1843-1845,1849,共4页Journal of Practical Radiology

摘　　要：目的回顾性总结CastellviⅡa型腰骶移行椎(LSTV)的CT征象,旨在提高对该病的认识,减少其CT漏诊率.方法以“CTL3~S1椎间盘平扫”为关键词在图片存储与传输系统(PACS)上查询2020年1月1日至2020年12月10日的CT图像资料共565例,经2名高年资影像诊断医师共同读片后诊断为CastellviⅡa型LSTV39例,在常规CT椎间盘轴位扫描图像上观察移行椎的横突、椎板、关节突、黄韧带及其头尾侧的椎间盘的形态学特征.结果39例CastellviⅡa型LSTV中18例右侧横突肥大、21例左侧横突肥大,均与骶椎形成假关节;34例两侧椎板夹角增大,平均为(135.9±6.3)°,另5例伴隐裂而不作椎板夹角测量;与肥大横突同侧的下位关节突发育较小且更趋于冠状位32例;LSTV头侧椎间黄韧带肥厚19例而尾侧椎间黄韧带未见增厚.LSTV头侧椎间盘突出17例、膨出14例,尾侧椎间盘均未见突出或膨出.结论常规的腰椎间盘CT检查中,CastellviⅡa型LSTV具有偏侧性横突肥大、偏侧性关节突发育较小且更趋于冠状位、头侧椎间盘突出或膨出而尾侧椎间盘正常、头侧椎间隙黄韧带肥厚而尾侧黄韧带正常、椎板夹角增大等CT特征.Objective To retrospectively summarize the CT features of Castellvi Ⅱ a lumbosacral transitional vertebrae(LSTV)and improve the accuracy of its diagnosis.Methods From January lst.2020 to December 10th.2020,565 patients scanned by routine CT for intervertebral disc disease were searched from picture archiving and communication system(PACS),of which 39 patients were diagnosed as Castellvi Ⅱ a LSTV by 2 senior diagnostic radiologists and CT characteristics of LSTV were observed on their intervertebral disc levels,including their transverse process,vertebral lamina,articular process,ligamentum flavum and intervetebral disc in the above and below.Results All Castellvi Ⅱ a LSTV in 39 patients had 18 right and 21 left enlarged transverse processes and their pseudo-articulation with sacrum.Enlarged included angle(135.9±6.3)°of bilateral vertebral lamina measured in 34 cases and not measured in the other 5 cases because of spina bifida occulta.Inferior facet processes on the same side of enlarged transverse process were dysplastic and more coronally oriented in 32 cases.Thickening of the ligamentum flavum above the LSVT were found in 19 patients and all the ligamentum flavum below the LSVT were not found.Intervertebral disc herniation above to the LSVT in 17 patients and bulging in 14 patients were observed,but no abnormality was found in the intervertebral discs below to the LVST.ConclusionOn routine CT for intervertebral disc examination,Castellvi Ⅱ a LSVT have some asymmetric CT characteristics,such as unilateral enlarged transverse processes,unilateral dysplastic and more coronally oriented inferior facet processes,herniation or bulging of intervertebral discs and thickened ligamentum flavum above to the LSVT versus normality of them below to the LVST,and enlarged included angleofbilateral vertebral plate.

关 键 词：腰骶移行椎 横突 假关节 计算机体层成像 

分 类 号：R681.57[医药卫生—骨科学] R814.42[医药卫生—外科学]