整形５６

【臨床症状】10代　側弯症精査

【問題】画像所見と診断名は？

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※ T2WI、T1WI、脂肪抑制の矢状断、T2WIの冠状断、横断像の順に表示

    ▶答えはこちら
    • Th-4に右半分が欠損した椎体を認める
    • この部分から側弯を認め、横断像にて胸髄が脊柱管に接しているのが確認できる
    • 上記より、半椎体（hemivertebra）と診断できる
    • 他、特に異常所見は無い

    【半椎体】

    ・椎体は胎生6週に左右2つの軟骨核が形成される

    ・8週前後でこれらの軟骨核が癒合し、一次性骨核が形成され、その後骨化していく

    ・ここで軟骨核片側の形成不全が起きると、左右どちらかの半椎体が生じる

    ・ほとんどの症例で側弯症を合併する

    ・胸椎に好発する

    参考書籍：骨軟部疾患の画像診断 第2版