中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
10期
81-82
,共2页
磁共振成像%腰椎间隙%腰大池引流
磁共振成像%腰椎間隙%腰大池引流
자공진성상%요추간극%요대지인류
Magnetic resonance imaging%Lumbar vertebral space%Lumbar cerebrospinal fluid drainage
目的 为探讨持续腰大池脑脊液引流(Continued lumbar cerebrospinal fluid drainage,CLCFD)穿刺点的解剖学依据和提高引流效果.方法 选择64例行腰椎MRI检查的成年人,正中矢状面扫描进行穿刺点解剖学测量分析,即从L3-4和L4-5椎间盘的中点做一与椎管垂直的直线,命名为H1和H2线;该线与椎管前后径交点的中点即为两椎间隙的测量点(A点为L3-4,B点为L4-5).分别测量A、B点到脊髓圆锥和硬膜囊终点的直线距离,H1和H2线与皮肤的交点S1和S1到蛛网膜下腔的距离.结果 S1和S1到蛛网膜下腔的距离分别为(51.3±7.4)mm,(53.3±8.4)mm.A、B点到脊髓圆锥的距离分别为(90.1±16.4)mm,(121.9±17.3)mm;A、B点到硬膜囊终点的直线距离分别为(91.1±14.4)mm,(61.6±13.0)mm.比较A、B点到脊髓圆锥的距离及B点到脊髓圆锥和硬膜囊终点直线距离的差异有统计学意义.结论 首选L4-5间隙穿刺头向置管;若选择L3-4间隙穿刺,头向和尾向置管都可行,但头向置管有利于引流.
目的 為探討持續腰大池腦脊液引流(Continued lumbar cerebrospinal fluid drainage,CLCFD)穿刺點的解剖學依據和提高引流效果.方法 選擇64例行腰椎MRI檢查的成年人,正中矢狀麵掃描進行穿刺點解剖學測量分析,即從L3-4和L4-5椎間盤的中點做一與椎管垂直的直線,命名為H1和H2線;該線與椎管前後徑交點的中點即為兩椎間隙的測量點(A點為L3-4,B點為L4-5).分彆測量A、B點到脊髓圓錐和硬膜囊終點的直線距離,H1和H2線與皮膚的交點S1和S1到蛛網膜下腔的距離.結果 S1和S1到蛛網膜下腔的距離分彆為(51.3±7.4)mm,(53.3±8.4)mm.A、B點到脊髓圓錐的距離分彆為(90.1±16.4)mm,(121.9±17.3)mm;A、B點到硬膜囊終點的直線距離分彆為(91.1±14.4)mm,(61.6±13.0)mm.比較A、B點到脊髓圓錐的距離及B點到脊髓圓錐和硬膜囊終點直線距離的差異有統計學意義.結論 首選L4-5間隙穿刺頭嚮置管;若選擇L3-4間隙穿刺,頭嚮和尾嚮置管都可行,但頭嚮置管有利于引流.
목적 위탐토지속요대지뇌척액인류(Continued lumbar cerebrospinal fluid drainage,CLCFD)천자점적해부학의거화제고인류효과.방법 선택64례행요추MRI검사적성년인,정중시상면소묘진행천자점해부학측량분석,즉종L3-4화L4-5추간반적중점주일여추관수직적직선,명명위H1화H2선;해선여추관전후경교점적중점즉위량추간극적측량점(A점위L3-4,B점위L4-5).분별측량A、B점도척수원추화경막낭종점적직선거리,H1화H2선여피부적교점S1화S1도주망막하강적거리.결과 S1화S1도주망막하강적거리분별위(51.3±7.4)mm,(53.3±8.4)mm.A、B점도척수원추적거리분별위(90.1±16.4)mm,(121.9±17.3)mm;A、B점도경막낭종점적직선거리분별위(91.1±14.4)mm,(61.6±13.0)mm.비교A、B점도척수원추적거리급B점도척수원추화경막낭종점직선거리적차이유통계학의의.결론 수선L4-5간극천자두향치관;약선택L3-4간극천자,두향화미향치관도가행,단두향치관유리우인류.
Objective To explore for anatomic basis and improve drainage effects on CLCFD.Methods The MR machine of Siemens Trio Tim 3.0 T was used to scan the normal spinal canal of 64 adult subjects.The datum was measured in the median sagittal section of the lumbar vertebral column.Through midpoint of lumbar L3-L4 and L4-L5 vertebral disc's,we painted vertical lines of vertebra,named H1 and H2 lines.The vertical line cross vertebral column at two points.The midpoint of two points is measured point(A is L3-L4,B is L4-L5).We measured distance from the junction of H1 or H2 lines and skin S1 or S1 to subarachnoid space,distance from A or B to the ending of spinal and dural pocket.Results The distance from S1 or S1 to subarachnoid space was (51.3 ±7.4)mm,(53.3 ±8.4)mm.A,B point to the ending of spinal were(90.1 ±16.4)mm,(121.9 ±17.3)mm.A,B point to the ending of dural pocket was(91.1 ±14.4)mm,(61.6 ±13.0)mm.The distance from A,B point to the ending of spinal and B point to the ending of spinal and dural pocket were statistically significance(P＜0.01).Conclusion Select lumbar L4-L5 puncture and cephalad implant catheter at first.It is possible to implant catheter cephalad or cauda if select lumbar L3-L4 puncture,but cephalad implant catheter is beneficial to the cerebrospinal fluid drainage.
