螺旋CT对正常成人下腰椎侧隐窝的研究

目的:研究正常人下腰椎侧隐窝的形态和测量方法,探讨对侧隐窝狭窄的诊断?方法:采用尸体标本解剖与螺旋CT多层面容积重建和表面遮掩显示相结合方法对侧隐窝进行观察,选择椎体上1/4横断面作为研究平面,测量120例下腰椎双侧侧隐窝矢状径?椎管正中矢状径,计算椎管正中矢状径与双侧侧隐窝矢状径的比值,分析其相互关系?结果:下腰椎侧隐窝分三型:三角型?三叶草型和牛角型;正常成人双侧侧隐窝矢状径不对称,右侧略大于左侧(P<0.05),椎管正中矢状径与双侧侧隐窝矢状径的比率相对恒定(P>0.05),正中/右侧=3.93,正中/左侧=4.03?结论:椎体上1/4横断面为侧隐窝入口平面,利用矢状径比值的方法来判断侧隐窝狭窄具有科学性?

Study on inferior lumbar lateral recess of normal adults by autopsy anatomy and helical CT

Objective: To investigate the morphology and measurement of lumbar lateral recess in normal adults and explore the diagnosis of lateral recess stenosis. Methods: Autopsy anatomy and helical CT (muti-plane volume reconstruction, MPVR and surface shading display, SSD) were used to observe the lateral recess. The upper 1/4 transverse plane was elected as study plane. The sagital diameters of lateral recess and medial sagittal diameters of vertebral canal of 120 lumbar vertebrae were measured and the ratios of them were calculated. U-test was used to test the results. Results: Inferior lumbar lateral recess could be classified into 3 types: triangular, clover and ox horn. The bilateral sagittal diameters of normal adults were asymmetry. The right side was slightly lager than the left side (P<0.05). The ratios of medial sagittal diameter of vertebral canal and sagittal diameter of bilateral lateral recess are relatively invariable: medial/right=3.93, medial/left=4.03. Conclusion: Electing upper 1/4 transverse plane of vertebrae as entrance plane of lateral recess, the method using sagittal diameter ratio to diagnose lateral recess stenosis is more scientific. [