| 翟晶,蔡爱露,董岚,蔡畅,李冬梅.腰骶关节两线相交法判定胎儿脊髓圆锥位置[J].中国介入影像与治疗学,2018,15(12):739-742 |
| 腰骶关节两线相交法判定胎儿脊髓圆锥位置 |
| Two-line intersection method of lumbosacral junction in localization of fetal conus medullaris |
| 投稿时间：2018-04-30 修订日期：2018-09-03 |
| DOI：10.13929/j.1672-8475.201804038 |
| 中文关键词: 腰骶关节 脊髓圆锥 胎儿 超声检查,产前 |
| 英文关键词:Lumbosacral junction Conus medullaris Fetus Ultrasonography,prenatal |
| 基金项目:“十二五”国家科技支撑计划项目（2014BAI06B05）。 |
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| 中文摘要: |
| 目的 探讨腰骶关节两线相交法定位胎儿脊髓圆锥的位置的可行性。方法 选取20~38周正常胎儿581胎，以腰骶关节两线相交法识别S1椎体，定位脊髓圆锥相应椎体水平，观察各孕周脊髓圆锥位置分布情况；随机选取101胎不同孕周胎儿观察不同医师间及腰骶关节两线相交法与三维成像定位结果的一致性。结果 2名医师采用腰骶关节两线相交法定位脊髓圆锥的一致性好（Kappa＝0.94）；腰骶关节两线相交定位与三维成像定位一致性好（Kappa＝0.92）。530胎腰骶关节两线相交法可识别S1椎体并定位脊髓圆锥，脊髓圆锥对应的椎体水平范围为L1~L4，其中对应L1椎体、L1-2椎间隙、L2椎体、L2-3椎间隙、L3椎体、L3-4椎间隙和L4椎体分别占4.72%（25/530）、8.68%（46/530）、51.32%（272/530）、19.62%（104/530）、11.89%（63/530）、2.26%（12/530）和1.51%（8/530）；脊髓圆锥随孕周呈逐渐上升趋势；≥23孕周时，全部位于L3椎体及以上；≥32孕周时，98.38%（182/185）达L2-3椎间隙及以上，≥37孕周时，94.83%（55/58）上升至L2椎体及以上。结论 通过腰骶关节两线相交法可识别S1椎体，进而准确定位脊髓圆锥水平，可用于快速判断脊髓圆锥位置。 |
| 英文摘要: |
| Objective To explore the feasibility of two-line intersection method of lumbosacral junction in localization of fetal conus medullaris. Methods A total of 581 normal fetuses with 20-38 weeks of gestational age were included. Two-line intersection method of lumbosacral junction was used to identify S1 vertebra and then counted upward to localize the fetal conus medullaris at the level of vertebral body. The distribution of conus medullaris position in each gestational age was observed. Then 101 fetuses in different gestational age were randomly selected to analyze the consistency of localization results within two operators and with three-dimensional imaging. Results The consistency of localization within two operators and two methods were both good (Kappa=0.94, 0.92). Two-line intersection method of lumbosacral junction could easily and clearly locate the conus medullaris in 530 fetuses, and the distribution of conus medullaris was L1 (25/530, 4.72%), L1-2 disc (46/530, 8.68%), L2 (272/530, 51.32%), L2-3 disc (104/530, 19.62%), L3 (63/530, 11.89%), L3-4 disc (12/530, 2.26%) and L4 (8/530, 1.51%). Furthermore, when gestational age was ≥ 23 weeks, all conus medullaris located at or above L3 level; when gestational age was ≥ 32 weeks, 98.38% (182/185) conus medullaris was at or above L2-3 level; when gestational age was ≥ 37 weeks, 94.83% (55/58) conus medullaris was at or above L2 level. Conclusion Two-line intersection method of lumbosacral junction could be used to identify S1 and locate the fetal conus medullaris accurately, therefore could be used to determine the position of conus medullaris quickly and conveniently. |
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