髂腰韧带的横断位CT表现及其在腰骶部椎体节段定位中的价值
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刘克昌 LIU Ke-chang 温州市龙湾区第一人民医院放射科,浙江 温州 325024 Department of Radiology, the First People Hospital of Longwang, Wenzhou 325024, Zhejiang, China lkc8963@126.com 
项光涨 XIANG Guang-zhang 温州市龙湾区第一人民医院放射科,浙江 温州 325024 Department of Radiology, the First People Hospital of Longwang, Wenzhou 325024, Zhejiang, China  
陈光华 CHEN Guang-hua 温州市龙湾区第一人民医院放射科,浙江 温州 325024 Department of Radiology, the First People Hospital of Longwang, Wenzhou 325024, Zhejiang, China  
周耀 ZHOU Yao 温州市龙湾区第一人民医院放射科,浙江 温州 325024 Department of Radiology, the First People Hospital of Longwang, Wenzhou 325024, Zhejiang, China  
曹晓青 CAO Xiao-qing 温州市龙湾区第一人民医院放射科,浙江 温州 325024 Department of Radiology, the First People Hospital of Longwang, Wenzhou 325024, Zhejiang, China  
夏建娣 XIA Jian-di 温州市龙湾区第一人民医院放射科,浙江 温州 325024 Department of Radiology, the First People Hospital of Longwang, Wenzhou 325024, Zhejiang, China  
李可 LI Ke 温州市龙湾区第一人民医院放射科,浙江 温州 325024 Department of Radiology, the First People Hospital of Longwang, Wenzhou 325024, Zhejiang, China  
期刊信息:《中国骨伤》2010年,第23卷,第11期,第854-858页
DOI:10.3969/j.issn.1003-0034.2010.11.018
基金项目:
中文摘要:

目的:初步研究髂腰韧带的横断位CT表现,重点探讨髂腰韧带在腰骶段移行椎中的定位作用。

方法:选2008年5月至2010年3月因腰背部症状拟诊椎间盘病变来院行CT扫描的706例患者,其中男436例,女270例;年龄25~82岁,平均44岁。所有患者均进行单层螺旋CT横断位扫描,其中移行椎患者78例,均经X线摄片或透视证实。在横断面CT图像上观察髂腰韧带的形态、位置及走行,了解其位置是否相对恒定;研究髂腰韧带与腰椎节段的关系,并与另外4种常用的腰骶椎节段CT定位方法作对照。

结果:628例具有正常腰骶节段的患者其髂腰韧带的主要部分均起自L5横突,止于髂嵴,3例可见髂腰韧带细小分支从L4,5椎间盘后外缘同时发出,其形态可分双束型占71.8%(451/628)及单束型占28.2%(177/628);78例移行椎患者的髂腰韧带亦起源于L5横突;以髂腰韧带作为L5椎体水平的定位标记,均得到准确定位,其准确率明显高于其他定位方法,与髂嵴定位法比较差异具有统计学意义(P<0.05).

结论:髂腰韧带主体起源于L5横突,其解剖位置相对恒定,可将其作为L5的解剖定位标志,以判断腰骶部移行椎类型和进行椎间盘定位。
【关键词】髂腰韧带  腰骶部  腰椎  体层摄影术,X线计算机
 
CT axial imaging of the iliolumbar ligament and its significance on locating lumbosacral vertebral segments
ABSTRACT  

Objective: To study the CT axial manifestations of iliolumbar ligament(ILL) and discusses its clinical effects on locating lumbosacral vertebral segments.

Methods: From May 2008 to March 2010,706 adult patients diagnosed lumbar disc disease were performed with axial scans by single slice helical CT. Among the patients,436 patients were male and 270 patients were female,ranging in age from 25 to 82 years,the median age was 44 years,78 cases with lumbosacral transitional vertebrae(LSTV)were verified by X-radiography or fluoroscopy. The morphology,origin and insertion,courses of ILL and the relationship of ligament and spinal segments on axial plane images were used to study. The location method of spinal segments by ILL was compared with the other four location methods on CT.

Results: Of the 628 cases with normal lumbosacral segmentations sides of ligament,the main part of ILL originated from L5 transverse processes and terminated at the iliac crest,the morphological characters were divided into two types:double band(71.8%,451/628) and single band(28.2%,177/628). The tiny branches from posterior and outside edge of L4,lumbar disc were seen simultaneity in 3 cases. The ILL of 78 cases with LSTV all also originated from L5 transverse processes. Using ILL as a marker of the L5 vertebral level,78 cases with LSTV were correctly numbered,the accuracy rate was higher than the other location methods,there was statistical significance between the location method by ILL and the location method by iliac crest(P<0.05).

Conclusion: The main part of ILL originates from L5 transverse processes,the anatomic location is relatively steady and can be clearly displayed on axial CT,which can be used as a measure in the idenlification of LSTV in clinical practice,it is worthy to be applied widely in basic-level hospitals.
KEY WORDS  Iliolumbar ligament  Lumbosacral region  Lumbar vertebrae  Tomography,X-ray computed
 
引用本文,请按以下格式著录参考文献:
中文格式:刘克昌,项光涨,陈光华,周耀,曹晓青,夏建娣,李可.髂腰韧带的横断位CT表现及其在腰骶部椎体节段定位中的价值[J].中国骨伤,2010,23(11):854~858
英文格式:LIU Ke-chang,XIANG Guang-zhang,CHEN Guang-hua,ZHOU Yao,CAO Xiao-qing,XIA Jian-di,LI Ke.CT axial imaging of the iliolumbar ligament and its significance on locating lumbosacral vertebral segments[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(11):854~858
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