Rojas C A, Vermess D, Bertozzi J C, Whitlow J, Guidi C, Martinez C R
Department of Radiology, University of South Florida College of Medicine, Tampa, FL33611, USA.
AJNR Am J Neuroradiol. 2009 Jan;30(1):136-41. doi: 10.3174/ajnr.A1307. Epub 2008 Nov 11.
Analysis of the prevertebral soft tissue (PVST) is helpful in detecting osseous and ligamentous injuries of the cervical spine. Because the standard of care has shifted from radiographs to multidetector CT (MDCT), a re-examination of the PVST on MDCT images is needed to establish normal values for thickness appropriate for this imaging technique.
Thickness of the PVST was measured in 192 patients undergoing screening cervical spine MDCT with multiplanar reconstructions as part of a trauma protocol. Patients included in the study were not intubated, had an immobilized cervical spine, had normal findings on cervical spine CT, and did not have a diagnosis of osseous or soft-tissue cervical injury. Exclusion criteria included patients with a congenital or acquired (nondegenerative) abnormality of the cervical spine or PVST.
The upper limits of normal for the thickness of the PVST were 8.5 mm at C1, 6 mm at C2, 7 mm at C3, 18 mm at C6, and 18 mm at C7. The upper limit of normal was not determined for C4 and C5 levels due to variable position of the esophagus and larynx. The smallest variability and calculated SDs were found at C2 and C3.
The thickness of the PVST is important in the detection of underlying injuries to the cervical spine. We propose the obtained values as the upper limits of normal for PVST thickness on MDCT images in the adult population.
分析椎前软组织（PVST）有助于检测颈椎的骨性和韧带损伤。由于医疗标准已从X线片转向多排CT（MDCT），因此需要重新检查MDCT图像上的PVST，以确定适用于该成像技术的厚度正常值。
在192例接受颈椎MDCT筛查并进行多平面重建的患者中测量PVST厚度，这是创伤检查方案的一部分。纳入研究的患者未插管，颈椎固定，颈椎CT检查结果正常，且未诊断为颈椎骨性或软组织损伤。排除标准包括患有颈椎或PVST先天性或后天性（非退行性）异常的患者。
PVST厚度的正常上限在C1为8.5mm，C2为6mm，C3为7mm，C6为18mm，C7为18mm。由于食管和喉部位置可变，未确定C4和C5水平的正常上限。在C2和C3处发现最小变异性和计算标准差。
PVST厚度对检测颈椎潜在损伤很重要。我们建议将获得的值作为成人MDCT图像上PVST厚度的正常上限。
