Cantürk Mehmet, Kocaoğlu Nazan, Hakki Meltem
Ahi Evran University Training and Research Hospital, Department of Anesthesiology and Reanimation, Kırsehir, Turquia.
Balikesir University Faculty of Medicine, Department of Anesthesiology and Reanimation, Balikesir, Turquia.
Braz J Anesthesiol. 2020 May-Jun;70(3):248-255. doi: 10.1016/j.bjan.2020.03.009. Epub 2020 Jun 18.
To assess the agreement between the epidural depth measured from the surgical site with the epidural depths estimated with magnetic resonance imaging (MRI) and ultrasound scanning.
Fifty patients of either sex, scheduled for L4‒5 lumbar disc surgery under general anesthesia were enrolled in this prospective observational study, and the results of 49 patients were analyzed. The actual epidural depth was measured from the surgical site with a sterile surgical scale. The MRI-derived epidural depth was measured from the MRI scan. The ultrasound estimated epidural depth was measured from the ultrasound image obtained just before surgery.
The mean epidural depth measured from the surgical site was 53.80 ± 7.67 mm, the mean MRI-derived epidural depth was 54.06 ± 7.36 mm, and the ultrasound-estimated epidural depth was 53.77 ± 7.94 mm. The correlation between the epidural depth measured from the surgical site and MRI-derived epidural depth was 0.989 (r = 0.979, < 0.001), and the corresponding correlation with the ultrasound-estimated epidural depth was 0.990 (r = 0.980, < 0.001).
Both ultrasound-estimated epidural depth and MRI-derived epidural depth have a strong correlation with the epidural depth measured from the surgical site. Preprocedural MRI-derived estimates of epidural depth are slightly deeper than the epidural depth measured from the surgical site, and the ultrasound estimated epidural depths are somewhat shallower. Although both radiologic imaging techniques provided reliable preprocedural estimates of the actual epidural depth, the loss of resistance technique cannot be discarded while inserting epidural needles.
评估从手术部位测量的硬膜外深度与通过磁共振成像（MRI）和超声扫描估计的硬膜外深度之间的一致性。
本前瞻性观察性研究纳入了50例计划在全身麻醉下进行L4 - 5腰椎间盘手术的患者，对49例患者的结果进行了分析。使用无菌手术尺从手术部位测量实际硬膜外深度。从MRI扫描测量MRI得出的硬膜外深度。从手术前获得的超声图像测量超声估计的硬膜外深度。
从手术部位测量的平均硬膜外深度为53.80±7.67mm，MRI得出的平均硬膜外深度为54.06±7.36mm，超声估计的硬膜外深度为53.77±7.94mm。从手术部位测量的硬膜外深度与MRI得出的硬膜外深度之间的相关性为0.989（r = 0.979，P<0.001），与超声估计的硬膜外深度的相应相关性为0.990（r = 0.980，P<0.001）。
超声估计的硬膜外深度和MRI得出的硬膜外深度与从手术部位测量的硬膜外深度均具有很强的相关性。术前MRI得出的硬膜外深度估计值比从手术部位测量的硬膜外深度略深，而超声估计的硬膜外深度略浅。尽管两种放射成像技术都能提供可靠的术前实际硬膜外深度估计值，但在插入硬膜外针时不能摒弃阻力消失技术。
