腰椎黄韧带肥厚骨化影像学研究现状.docVIP

腰椎黄韧带肥厚骨化影像学研究现状 　　[摘要] 腰椎黄韧带肥厚骨化已成为腰椎非骨性椎管狭窄的常见致病因素，断层影像学上观测到黄韧带肥厚骨化厚度超过4 mm时，被公认为是一个诊断黄韧带肥厚的指标，但是由于人体骨性椎管大小的差异，所以单纯用黄韧带厚度来判断椎管狭窄，难免出现个别诊断与临床症状不符的现象。本文对黄韧带肥厚骨化的三维立体可视化研究进行综述，总结其规律，为临床术诊断提供依据。 　　[关键词] 腰椎；黄韧带；肥厚骨化；影像学 　　[中图分类号] R816.8 [文献标识码] A [文章编号] 1673-7210（2014）02（a）-0152-03 　　Current research on the imaging of lumbar ligamentum flavum hypertrophy and ossification 　　SUN Ruifen1 YU Jinghong1 LI Zhijun2 　　1.Department of Image， the Second Affiliated Hospital of Inner Mongolia Medical University， Inner Mongolia Autonomous Region， Hohhot 010030， China； 2. Anatomy Teaching and Research Section， Inner Mongolia Medical University， Inner Mongolia Autonomous Region， Hohhot 010059， China 　　[Abstract] Hypertrophy and ossification of lumbar ligamentum flavum has been suggested as a common cause for the spinal stenosis. Using tomographic imaging to observe， when lumbar ligamentum flavum hypertrophied or ossified more than 4 mm， it has been widely recognized as a diagnostic indicator. However， due to human spinal cord anatomical differences， if only using the thickness of the ligamentum flavum to determine spinal stenosis， it may occur the phenomena that the diagnosis might not match the clinical symptoms. At present， this article commonly combine conventional MRI with sagittal CT to reformat the image for comprehensive evaluation in practice. This article studied the development of the 3D simulation on hypertrophy and ossification of lumbar ligamentum flavum， and it would provide three-dimensional intuitive anatomical diagnostic foundations for clinical surgical procedures. 　　[Key words] Lumbar spine； Ligamentum flavum； Hypertrophy and ossification； Imaging 　　腰椎黄韧带肥厚骨化是黄韧带肥厚及钙盐沉着为特征的退行性改变，是引起椎管狭窄的重要因素，可导致一系列脊髓或马尾神经压迫症状如腰腿痛、间歇性跛行等，给患者带来巨大痛苦[1]，因此对于黄韧带的研究一直不曾间断，分别有黄韧带肥厚的解剖、病理机制???病因以及组织生物力学测定等[2-7]。随着医学影像学的发展，对黄韧带肥厚、骨化的各种影像学研究也不断深入，现对其作一综述。 　　1 普通影像学研究现状 　　1.1 普通X线平片与X线脊髓造影 　　因黄韧带为软组织密度，X线上与椎体骨性密度及椎管内其它软组织影重叠不易区分，普通X线平片对非骨化的黄韧带不能显示，只有当黄韧带外侧部骨化严重或者突入椎管内[8]，可在侧位X线片上