Milicić Gordana, Krolo Ivan, Vrdoljak Javor, Marotti Miljenko, Roić Goran, Hat Josip
Department of Orthopedics, Children's Hospital Zagreb, Zagreb, Croatia.
Coll Antropol. 2006 Mar;30(1):55-8.
Identification of the lumbosacral (L-S) segment on magnetic resonance (MR) images is important for appropriate treatment of disease in the lumbosacral (L-S) area. In the study, data obtained from plain A-P radiographs of the L-S spine and sagittal MR imaging scans (sagittal T1- and T2-weighted sequences) of the L-S spine and sacrum with the coccygeal bone, are analyzed. Twenty-six children aged 10 to 14 years were examined for back pain. On the standard A-P radiographs of the L-S spine, a L-S transitional vertebra as classified according to the method of Castellvi et al. was found in 17 subjects. The problem arose as to whether this was lumbalisation or sacralisation, and how to determine which vertebra was L5 wich S1. On the sagittal MR imaging studies the same question applied. A need emerged for a simple method which would identify the L-S segment on the sagittal MR imaging studies of the L-S spine in children so that in case of a tumor, inflammation, spondilolystesis, or protrusion of a disc, the level in the L-S spine where the problem is localized can be accurately identified. To this objective we selected the method using detection of the S1 vertebra. This involved that, in addition to the sagittal MR imaging scans of the L-S spine, sagittal images of the sacrum and coccygeal bone be also obtained. on the T2-weighted sequence, the sacrum can be clearly distinquished from the coccygeal bone. By counting from the S5 up, the S1 vertebra can be accurately identified. Determination of the S1 vertebra enables detection of the L5 vertebra and, in turn, of all other lumbar vertebrae. In patients in whom a T2-weighted MR studies were done S1 could be precisely determined and so could the L5 vertebra. In this process, whether the patient had a transitional vertebra or whether there was lumbarisation or sacralisation was irrelevant.
在磁共振（MR）图像上识别腰骶（L-S）节段对于恰当治疗腰骶（L-S）区域的疾病很重要。在本研究中，分析了从腰骶部脊柱的前后位平片以及腰骶部脊柱和包含尾骨的骶骨的矢状面MR成像扫描（矢状面T1加权和T2加权序列）获得的数据。对26名10至14岁因背痛接受检查的儿童进行了研究。在腰骶部脊柱的标准前后位平片上，按照Castellvi等人的方法分类，在17名受试者中发现了腰骶移行椎。问题在于这是腰椎化还是骶椎化，以及如何确定哪个椎体是L5哪个是S1。在矢状面MR成像研究中也存在同样的问题。因此需要一种简单的方法，能够在儿童腰骶部脊柱的矢状面MR成像研究中识别L-S节段，以便在出现肿瘤、炎症、椎体滑脱或椎间盘突出时，可以准确识别腰骶部脊柱中问题所在的节段。为了实现这一目标，我们选择了通过检测S1椎体的方法。这需要除了腰骶部脊柱的矢状面MR成像扫描外，还需获取骶骨和尾骨的矢状面图像。在T2加权序列上，可以清楚地将骶骨与尾骨区分开来。从S5向上计数，可以准确识别S1椎体。确定S1椎体能够进而检测出L5椎体以及所有其他腰椎椎体。在进行了T2加权MR研究的患者中，可以精确确定S1椎体，进而也能确定L5椎体。在此过程中，患者是否有移行椎，以及是否存在腰椎化或骶椎化都无关紧要。
