颈椎及其毗邻结构的超声检查与临床意义

目的探讨颈椎及其毗邻结构的超声检查方法与临床意义。方法对50例健康成人颈部进行超声检查,重点描述颈椎及其毗邻结构的扫查方法与声像图特点。结果(1)颈椎棘突扫查图像:颈椎棘突呈"栅栏样"声像,寰椎有"拱桥形"的后弓与"山丘状"的后结节,枢椎棘突宽大且末端分叉,而隆椎拥有高大突出的棘突。(2)寰枕关节与寰枢外侧关节扫查图像:颈2背根神经节位于寰枢外侧关节后内侧,椎动脉在寰枢外侧关节后外侧上行,之后走行于寰枕关节下方侧块背侧。(3)颈椎小关节纵切扫查图像:后面观呈"叠瓦状"图像;侧面观呈"波浪线"图像,颈神经后内侧支走行于波谷处。(4)颈椎横突横切扫查图像:颈6横突前、后结节呈"驼峰征",颈6神经根位于两结节间的深沟内;颈7横突仅有一个巨大的后结节,颈7神经根位于后结节前方。(5)颈椎钩突与钩椎关节扫查图像:钩突外侧紧邻椎动脉,内侧为椎间盘;钩椎关节呈"裂缝样"图像。结论超声是检查颈椎及其毗邻结构的理想方法。

Ultrasound of the Cervical Spine and Its Adjacent Structures:Methods and Clinical Significance

Objective To explore the scanning methods and clinical significance of ultrasonogrpahy on the cervical spine(CS)and its adjacent structures.Methods Fifty healthy adults were examined by ultrasonography,focusing on the scanning methods and sonographic features of CS and its adjacent structures.Results(1)Sagittal scanning through the spinous processes(SP)revealed that they were arranged like a fence and C1 had only a dumpy tubercle.Transverse scanning shown C1 had a cambered posterior arch but C2 owned a bifid tip of SP.(2)Transverse scanning through the lateral atlanto-axial joint revealed that the second dorsal root ganglia lied posteromedially and the vertebral artery(VA)lied posterolaterally.Under the atlanto-occipital joint,VA passed through the lateral mass posteriorly.(3)Sagittal scanning through the facet joints(FJ)presented as the"imbrication"sign from the reare and as the"crests and troughs"sign from the side.The medial branches were located in the troughs.(4)Transverse scanning through transverse process(TP)shown that the C6 anterior and posterior tubercles(AT&PT)presented as the"two-humped camel"sign and the C6 nerve roots(NR)were in between;C7 TP had only a prominent PT and the C7 NR was anterior to it.(5)Transverse scanning through uncinate processes revealed that it was close to VA laterally and near to intervertebral disc medially.Sagittal scanning through uncovertebral joint presented as the"crevice"sign.Conclusions Ultrasonography is an effective tool to examine the cervical spine and its adjacent structures.