正常国人腰段椎管内硬膜外背侧脂肪含量的影响因素分析

目的：探讨正常国人椎管内硬膜外背侧脂肪含量的相关影响因素。方法：在 MRI 正中矢状面图像上统计263例正常国人腰段椎管硬膜外背侧脂肪厚度,计算其中120例相应层面椎管前后径,同时计算其中50例的体重指数。将263例分为青壮年组（18～59岁,207例）和老年组（≥60岁,56例）;腰椎生理弯曲度分为三级,即明显变直、轻度变直和正常曲度。结果：腰段硬膜外各节段背侧脂肪含量均与体重指数、椎管前后径及生理弯曲度呈正相关;老年组 L3／4节段硬膜外背侧脂肪含量厚度小于青壮年组,其余节段两组间差异无统计学意义（P ＞0．05）;不同性别间硬膜外背侧脂肪厚度差异无统计学意义（P ＞0．05）。结论：正常国人腰段椎管内硬膜外背侧脂肪含量与体重指数、椎管前后径及腰椎生理弯曲度相关,与年龄、性别无相关性。     

跟腱损伤的MRI诊断及临床分析

目的探讨跟腱损伤的MR I诊断价值及不同损伤程度的诊断标准。方法搜集经临床及手术证实的、MR I资料完整的外伤性跟腱损伤26例,总结其特征性MR I表现,并与10例正常跟腱进行回顾性对比观察。结果(1)正常跟腱10例表现为走行规则、边缘光滑,在T1W I、T2W I上呈均匀低信号;(2)部分性跟腱损伤17例,MR I表现为肌腱增粗、宽径/前后径比例变小,在T1W I、T2W I上肌腱内局限性高信号,肌腱束部分毛糙、不规则,但在矢状位至少有1个层面是连续的;(3)完全性跟腱损伤9例,MR I特征性表现为肌腱增粗、形态不规则,肌腱束连续性完全中断,肌腱断端交错呈“毛刷”状或回缩呈“杵”状改变,在T1W I、T2W I上其内呈混杂高信号;(4)7例合并骨挫伤及软组织损伤,2例合并韧带损伤,2例合并骨软骨损伤,11例合并腱周积液。结论MR I能够准确判断跟腱损伤的性质、范围、程度及合并症,对术前制订治疗方案及术后疗效分析具有重要价值。     

颈椎管狭窄的影像学分析

一般资料本组33例患者，全部摄取颈椎侧位、双斜位及正位片，26例行CT常规扫描，均采用椎管比值(颈椎管率)法测量，即：椎管比值=颈椎椎管矢状径(mm)/颈椎椎体矢状径(mm)。颈椎椎管矢状径测量：为椎体后缘中点到椎板连线中点间的距离，颈椎矢状径测量：为椎体前缘中点心至椎体后缘间距离。正常两者之比值应在0．75以上     

颈椎间盘突出的CT表现

本文报告37例颈椎间盘突出。CT图像上的直接征象为椎间盘向椎管内突入的软组织块影。间接征象是硬膜外脂肪、硬膜囊,蛛网膜下腔、脊髓和神经根鞘袖受压改变。椎间盘突出厚度与椎管矢状径之比称之为椎管狭窄率。脊髓受压程度与该率大小有关,当该率为19％左右时,没有或仅有下肢轻微不适;32％左右时,可有下肢无力、步行不便;48％左右时,步行困难或卧床不起。11mm可作为国人颈椎管矢状径的正常下限。     

椎管内蛛网膜囊肿的MRI诊断

目的探讨椎管内蛛网膜囊肿的MR I表现。方法搜集20例经MR I检查,手术病理证实的椎管内蛛网膜囊肿进行回顾性分析,其中男8例,女12例,行横断面及矢状面MR常规SE序列扫描,12例加做Gd-DTPA增强扫描。结果椎管内硬膜外蛛网膜囊肿5例,椎管内硬膜下蛛网膜囊肿6例,骶管内蛛网膜囊肿8例,神经鞘膜囊肿1例。囊肿信号与脑脊液信号相同,呈长T1、长T2信号,增强扫描无强化。结论MR I是诊断椎管内蛛网膜囊肿的最佳方法,平扫加增强扫描有助于诊断和鉴别诊断。     

颈椎某些正常和异常的界限Ⅱ:细微和隐蔽的异常

由于颈椎不同部分相互间重叠,邻近结构的复盖,及不适当的体位,可使颈椎某些异常遗漏或误诊。1.椎管矢状径较短:常颈椎椎管横切面呈三角形,横径大于前后径,脊髓呈圆形。颈椎椎管矢状径的长短变异较大,成人从颈_3至颈_7,测量范围为13～22毫米。当椎体后缘骨赘形成,椎间盘退行性变时,可产生同一平面椎管矢状径变短。椎体向后半脱位和过度伸展时,矢状径也可缩短。前后径缩短,即棘突基部和同一椎体或另一椎体的椎体后     

颈后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病

目的探讨颈后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病的疗效及手术前后影像学变化。方法用颈后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病病人68例,用JOA17分法评价术前,术后功能恢复及临床症状消失的情况,测量术前术后椎管矢状径变化。结果 68例患者均获随访,随访时间平均12.3个月,术后病人均获不同程度症状改善。术后颈椎椎管矢状径扩大明显。结论该术式治疗多节段脊髓型颈椎病具有操作简单、安全性高、疗效确切的优点,并且只有严谨操作和围术期处理,才能有效避免各种并发症的发生。早期手术可防止脊髓损伤继续加重。     

高场MRI斜矢状位与斜冠状位扫描在贲门癌术前检查中的应用价值

目的:探讨改进高场MRI斜矢状位与斜冠状位扫描在贲门癌术前检查中的应用价值.方法:回顾性分析69例贲门癌患者的MR I图像资料,MR I检查均采取平行于食管下段长轴的斜矢状位、斜冠状位和标准正矢状位、正冠状位的扫描方法.两位MR I诊断医师采用双盲法根据食管MR I图像评判两种不同扫描方法下距离肿块边缘的食管胸下段及腹...     

下期要目预告

低剂量多巴酚丁胺负荷MR结合心肌标记技术在心肌缺血中的应用;土贝母皂甙微囊栓塞治疗兔肾VX2移植癌的研究;肺炎双球菌及博莱霉素所致肺泡炎影像学表现及其病理对照研究;多体素1H-MRS在脑肿瘤强化周围区域中的临床应用;正常成人胸段椎管内脂肪的MR I研究;薄块M IP在听小骨显示中的作用评价;结合M icor CT技术的上颌第一前磨牙三维模型的建立;初治涂阳肺结核临床治愈后X线动态观察;SARS的影像学动态随访(附15例报告);肝内管道CT三维重建在囊性肝包虫病中的应用研究及意义;脾脏淋巴瘤的CT诊断;螺旋CT多期增强及其图像后处理技术在…     

椎管内原发性淋巴瘤的MRI表现

目的探讨MRI对椎管内原发性淋巴瘤诊断和鉴别诊断的价值。方法搜集经手术或穿刺病理证实的椎管内原发性淋巴瘤19例,行全身骨显像检查均未见确切骨转移征象,行骨髓穿刺检查均呈阴性,结合临床特征回顾性分析其MRI表现。结果 19例MRI表现为椎管内硬膜外软组织肿块,矢状面呈长条形,横断面呈半月形,14例向椎管外呈钻孔样生长。12例合并相邻椎骨骨质破坏,多位于椎弓附件区,其中8例软组织肿块范围大于骨质破坏范围,5例伴有压缩性骨折。软组织肿块信号均匀,边界清楚,以T1WI等信号、T2WI稍高信号为主,脂肪抑制序列呈高信号,增强后呈轻中度均匀或不均匀强化。骨质破坏为斑片状T1WI低信号,T2WI低或高信号,脂肪抑制序列呈高信号,结论椎管内原发性淋巴瘤MRI表现有一定的特征,把握这些特征有助于做出正确的诊断和鉴别诊断。     

MRI of normal spinal epidural fat]

The authors perform a retrospective study of 65 spines examined with MRI. They specify the distribution of normal posterior epidural fat and establish the relationship between the anteroposterior thickness of epidural fat and the sagittal diameter of the spine on axial sections. On sagittal sections, the fat has a variable appearance, but a constant location along the spinal canal.     

正常成年人骶管内硬膜外脂肪的MRI研究

目的:利用磁共振成像,建立健康成年人骶管硬膜外脂肪的正常值范围,为临床诊断提供参考基础及影像依据。方法:选择164例正常成年人(平均年龄41.4岁)行腰骶椎磁共振(MRI)扫描,分别测量骶椎各水平前、后硬膜外脂肪(AEF、PEF)的厚度,获得均数及标准差,并以性别、年龄及体重指数分组,进行组间比较及相关因素分析。结果:T1WI正中矢状面上S1~S5水平,硬膜外脂肪厚度平均值依次为6.97 mm、4.94 mm、5.53 mm、5.02 mm及3.86 mm,呈显著下降趋势。结论:本研究为临床确诊硬膜外脂肪增多、寻找神经根受压原因及骶管麻醉时入路方式的选择提供了重要的影像学参考标准。     

MRI of the spinal epidural fat in pathology]

The authors report about their experience with the merits of the normal systematization of epidural fat with MRI. On sagittal sections, this fat has a variable appearance, but its location along the spinal canal is constant. On axial sections, its morphology is suggestive of the level of section: cervical, upper or lower thoracic, lumbar. Some changes in this fat are precious data to explain local hypertrophy (scoliosis) or to locate an intra- or extradural process.     

MRI of acute spinal epidural hematomas.

PURPOSE: The purpose of this work was to determine the MR findings that characterize acute spinal epidural hematomas (ASEHs). METHOD: The MR findings of 17 patients with ASEH (9 cervical, 7 thoracic, and 2 lumbar) were reviewed. Fifteen of the hematomas were secondary to trauma and two were spontaneous. Correlation with CT (8 cases) and surgical findings (11 cases) was also performed. RESULTS: Imaging findings in ASEH were the following: (a) a variable signal intensity (on T1-weighted images, 10 showed isointensity to cord and 7 were slightly hyperintense; T2-weighted images showed hyperintensity with areas of hypointensity); (b) capping of epidural fat; (c) direct continuity with the adjacent osseous structures; (d) compression of epidural fat, subarachnoid sac, and spinal cord; (e) usually posterolateral location in the spinal canal. CONCLUSION: Epidural hematomas in the spinal canal are lesions capable of producing sudden spinal cord and/or cauda equina compression. MR provides characteristic findings that allow a prompt diagnosis of acute epidural hematomas.     

Epidural venous stasis in spinal stenosis

Summary Computed tomography permits reliable demonstration of the spinal canal and its contents. Measurements of the sagittal diameter of the bony canal do not take into consideration size, shape and state of intraspinal soft tissue structures, i.e. the thecal sac and its own contents, epidural fat and blood circulation pattern. Three particularly illustrative cases were selected in which obvious epidural venous engorgement was visualized in association with spinal stenosis. The authors think that epidural venous stasis occuring in segmental spinal stenosis is a CT sign of clinically significant narrowing of the neural canal. Accurate recognition of the type of lumbar stenosis together with epidural blood flow alterations permits a better understanding of the existing lesions. Thus, a more precise and specific surgical approach is possible.     

Normal and degenerative posterior spinal structures: MR imaging

A retrospective study of the magnetic resonance (MR) images of the lumbar spines of 13 healthy subjects and 30 patients with degenerative changes was done. In the healthy subjects, the vertebral facets, thickness of the cartilage and ligamentum flavum, signal characteristics of the bone marrow, and size of the spinal canal were studied. In the patients with degenerative changes in one of these structures, MR images in the sagittal plane were useful in demonstrating hypertrophy of the ligamentum flavum or the vertebral facets, in grading the degree of foraminal stenosis, and in measuring the sagittal diameter of the spinal cord. MR images in the axial plane facilitated detailed analysis of the facet joint and more accurate measurements of the thickness of the ligamentum flavum and spinal canal diameter. MR images were compared with computed tomography scans in 12 patients.     

Development of a mathematical model of the cervical spinal canal and its use in detecting early pathologic changes

Summary Detection of subtle osseous changes on plain film roentgenograms of the cervical spine is essential in expediting the evaluation of suspected intraspinal tumors. It is our experience that the earliest osseous changes in such cases involve thinning or erosion of the adjacent pedicles and/or lamina and a subsequent increase in the oblique diameter of the cervical spinal canal. A statistical model is established which accurately describes the normal cervical vertebral column in terms of its spinal canal size (sagittal and oblique diameters) as well as pedicle and lamina thickness. Data was obtained from a series of 86 normal exams. Six surgically proven cases of cervical intraspinal tumors were analyzed using this model. Variations from expected normal values reveal statistically significant osseous changes involving thinning of the lamina and increased oblique diameter of the spinal canal, while the sagittal diameter of the canal remains normal. Because of these findings we feel that oblique cervical spine films should be included in the initial evaluation of neural canal tumors.     

原发性椎管内淋巴瘤MRI探讨

目的：探讨原发性椎管内硬膜外淋巴瘤MRI表现。方法：收集经手术病理证实椎管内硬膜外淋巴瘤患者6例,对病例的MRI表现进行回顾性分析。结果：6例患者中,发生于胸椎5例、腰椎1例。MRI扫描显示肿瘤位于椎管内硬膜外,肿瘤呈纵向梭形生长,脊髓受压变形,形状不规则。T1WI呈等信号（4例）或稍低信号（2例）,T2WI为高信号,增强扫描时病灶均匀强化。5例为非霍奇金B细胞型淋巴瘤,另1例为非霍奇金T细胞型淋巴瘤。结论：原发性椎管内淋巴瘤在发病部位,病变形态和强化信号上具有一定特征,正确认识有利于提高对本病的诊断和鉴别诊断。