| 腰椎间孔狭窄症的MRI图像分析与临床意义 |
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投稿时间：2010-03-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 周辉 |
ZHOU Hui |
杭州市中医院骨伤科, 浙江 杭州 310007 |
Department of Orthopaedics,the Hospital of Traditional Chinese Medicine of Hangzhou,Hangzhou 310007,Zhejiang,China |
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| 董刚 |
DONG Gang |
杭州市中医院骨伤科, 浙江 杭州 310007 |
Department of Orthopaedics,the Hospital of Traditional Chinese Medicine of Hangzhou,Hangzhou 310007,Zhejiang,China |
dgg1206@163.com |
| 黄海 |
HUANG Hai |
杭州市中医院骨伤科, 浙江 杭州 310007 |
Department of Orthopaedics,the Hospital of Traditional Chinese Medicine of Hangzhou,Hangzhou 310007,Zhejiang,China |
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| 夏志敏 |
XIA Zhi-min |
杭州市中医院骨伤科, 浙江 杭州 310007 |
Department of Orthopaedics,the Hospital of Traditional Chinese Medicine of Hangzhou,Hangzhou 310007,Zhejiang,China |
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| 张政宏 |
ZHANG Zheng-hong |
杭州市中医院骨伤科, 浙江 杭州 310007 |
Department of Orthopaedics,the Hospital of Traditional Chinese Medicine of Hangzhou,Hangzhou 310007,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第8期，第587-590页 |
| DOI：10.3969/j.issn.1003-0034.2010.08.009 |
| 基金项目:浙江省医药卫生科研基金项目(编号：2007A160) |
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中文摘要:
目的：通过对腰椎旁矢状位MRI图像的分析，探讨影响腰椎间孔形态、孔内神经根周围环境的主要因素，寻找在腰椎旁矢状位MRI图像上评价腰椎间孔狭窄症(LPS)的主要量化指标。
方法：2007年1月至2009年8月接受MRI检查，并经手术证实为LPS的35例MRI图像进行系统回顾性分析，其中男27例，女8例；年龄35～82岁，平均54.5岁；病史4个月～8年，平均32个月。同时与37例正常腰椎间孔的MRI图像作对比性研究，观察两组资料矢状位MRI图像上L4,5、L5S1椎间孔有效空间的垂直径、上位矢状径、根孔比例，分析引起LPS的主要因素。
结果：LPS组L4,5、L5S1椎间孔有效空间的垂直径、上位矢状径小于正常组，椎间孔有效空间的根孔比例大于正常组。腰椎间盘、纤维环后外侧突出，黄韧带肥厚是LPS的主要软组织性因素；关节突关节、椎体后外缘终板平面增生肥大，骨赘突入椎间孔是LPS的主要骨性因素；神经根的水肿、粘连是LPS的主要根性因素，且多种因素往往复合存在。
结论：软组织性、骨性、根性因素的复合引起LPS,MRI检查可以充分显示LPS的解剖形态及引起LPS的病理改变，腰椎间孔有效空间的上位矢状径、垂直径、根孔比例可以作为腰椎旁矢状位MRI图像上评价LPS的量化指标。 |
| 【关键词】腰椎间孔狭窄症 磁共振 病理状态,解剖学 |
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| MRI finding of the lumbar foraminal stenosis and its clinical significance |
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ABSTRACT
Objective: To observe morphological changes of lumbar intervertebral foramen and pathologic changes around the nerve root and to explore the main evaluation index for lumbar foraminal stenosis(LPS) in parasaggital MRI finding.
Methods: From Jan.2007 to Aug.2009,MRI finding in 35 patients with the LPS that were confirmed by surgery was retrospectively analyzed. This group including 27 males,8 females;aged from 35 to 82 years with the mean of 54.5 years;the course was from 4 months to 8 years with the mean of 32 months. At the same time compared with another group including 37 cases whose MRI finding of foramen were normal. To find out the differences between two groups in effective foraminal height,effective superior foraminal width,the effective ratio of nerve root cross-sectional area and foramen cross-sectional area by analyzing the parasaggital MRI finding of L4,5 or L5S1 foramen. To analyze the main factors that included LPS.
Results: Effective foraminal height and effective superior foraminal width in L4,5 or L5S1 foramen in LPS group was smaller than that of control group (P<0.01). The effective ratio in LPS group was larger than that of control group (P<0.01). A variety of interacting factor were included LPS. Degeneration of the vertebral disk and hypertrophic ligamentum flavum were the main factors of soft tissue. Hypertrophy of the articular process and osteophyte on border of the vertebral body were the main factors of bone tissue. The edema and adhesion of nerve root with adjacent tissue were the main factors of nerve root.
Conclusion: The compound factors of soft tissue,bone tissue and nerve root resulted in LPS. MRI can adequately demonstrate anatomic structure of the foramen and pathologic changes of LPS. Effective foraminal height,effective superior foraminal width and the effective ratio can regard as the main evaluation index for LPS in parasaggital MRI finding. |
| KEY WORDS Lumbar foraminal stenosis Magnetic resonance Pathological conditions,anatomical |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 周辉,董刚,黄海,夏志敏,张政宏.腰椎间孔狭窄症的MRI图像分析与临床意义[J].中国骨伤,2010,23(8):587~590 |
| 英文格式: | ZHOU Hui,DONG Gang,HUANG Hai,XIA Zhi-min,ZHANG Zheng-hong.MRI finding of the lumbar foraminal stenosis and its clinical significance[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(8):587~590 |
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