颈胸段前路内固定器械的相关MRI影像解剖学研究

目的：通过MRI测量脊柱颈胸段（C7-T4）相关影像解剖学数据,为颈胸段前路内固定器械的设计、研发及前路手术的术前计划提供影像学参考。方法：自2012年8月至2013年4月间,在医院图像存贮及传输系统（PACS）影像工作站中随机抽取100例包含颈胸段的正常颈椎MRI图像,测量正中矢状面上C7-T4各椎体的相关影像学数据,包括椎体上矢状径、中矢状径、下矢状径,椎体前高、中高、后高,各节段的节段长度及Cobb角度,各椎体螺钉的长度。结果：脊柱颈胸段椎体矢状径逐渐增大,且同一椎体下矢状径大于上矢状径。各椎体后高均大于椎体前高,从而维持了颈胸段的生理性后凸,满足了负重递增的要求。正中矢状位上,头端螺钉长度为14.22-23.52 mm,尾端螺钉长度为15.29-26.13 mm。结论：在行颈胸段前路内固定时,需依据术前MRI影像测量结果,选择合适长度的钢板,并根据相应角度预弯,达到最佳固定效果。

MRI imaging anatomy study on anterior internal fixation devices of cervicothoracic junction

Objective： To measure the MRI imaging data of cervicothoracic junction（C7~T4 segments） in order to provide imaging reference for design and research of the anterior internal fixation devices, as well as the preoperative plan. Methods： From August 2012 to April 2013, 100 normal cervical MRI images were randomly selected form PACS to measure the relative data in median sagittal plane MRI photographs,including the upper, middle and lower sagittal diameter of vertebral; anterior, central and posterior height; anterior height and Cobb angle of different segment, and the screw length of every vertebral body. Results： The cervicothoracic junction sagittal diameter increases gradually, and the lower sagittal diameter was longer than the upper one of the same vertebral body. The posterior height was higher than the anterior＇s, thereby maintaining physiological thoracic kyphosis, and meeting the increasing load of body. The length of head-end screw ranges from 14.22 mm to 23.52 mm, and the tail-end one 15.29~26.13 mm. Conclusion： Preoperative MRI scan can guide us to choose the right size plate and prebend it, during the anterior internal fixation of cervicothoracic junction, and achieve the best fixation effect.