摘要
目的探讨MRI在颈椎管狭窄伴脊髓损伤中的诊断价值。方法回顾分析1998年8月-2008年5月收治的41例颈椎管狭窄伴脊髓损伤患者的MRI资料。其中男34例,女7例;年龄32～71岁,平均53.4岁,60岁以上患者27例。高处坠落伤8例,车祸伤19例,重物砸伤3例,其他伤11例。受伤至入院时间2h～3年。前脊髓损伤综合征12例,脊髓中央综合征23例,Brown-Sequard综合征6例。JOA脊髓功能评分为3～11分,平均6.6分。结果患者术前MRI诊断显示:颈脊髓信号异常37例41个部位;前后纵韧带和椎间盘(anterior and posterior longitudinal ligaments and discs,APLLD)损伤28例35处;椎前间隙软组织水肿血肿(edemas and hematoma signals in anterior surface of cervical spines,EBC)信号34例36处。术中见颈椎后方软组织水肿血肿挫伤撕裂18例20处,附件骨折6例7处,明显EBC信号20例23处,APLLD损伤断裂34例44处,椎间有不稳定而无韧带和椎间盘破裂7例10处。MRI显示和术中发现差异均有统计学意义(P<0.05)。结论术前MRI检查与术中发现不对应,MRI诊断有误差,不能对颈椎管狭窄伴脊髓损伤作出较全面准确诊断,建议结合临床症状进行诊断。
Objective To investigate the diagnostic value of MR imaging in cervical spinal canal stenosis combined with spinal cord injury. Methods From August 1998 to May 2008, 41 patients with cervical spinal canal stenosis and spinal cord injury were treated, including 34 males and 7 females aged 32-71 years （average 53.4 years, 27 patients being older than 60 years）. Patients＇ MRI data were retrospectively analyzed. Injury was caused by falling from height in 8 cases, traffic accident in 19 cases, crush due to heavy objects in 3 cases and other reasons in 11 cases. The time from injury to operation ranged from 2 hours to 3 years. There were 12 cases of anterior spinal cord injury syndrome, 23 of central spinal cord syndrome and 6 of Brown-Sequard syndrome./OA score of spinal cord function was 3-11 points （average 6.6 points）. Results MR imaging diagnosis before operation showed abnormal signal changes within the spinal cord in 37 cases （41 sites）, anterior and posterior longitudinal ligaments and discs （APLLD） injury in 28 cases （30 sites） and signal of edema and hematoma signals in anterior surface of cervical spines （EBC） in 34 cases （36 sites）. Diagnosis during operation revealed edemas braises, contusions tears of posterior soft tissue in 18 cases （20 sites）, appendix fracture in 6 cases （7 sites）, formation of EBC in 20 cases （23 sites）, APLLD injury in 34 cases （44 sites）, intervertebral instability without the rupture of ligament and intervertebral disc in 7 cases （10 sites）. Significant difference was evident between the MRI diagnosis before operation and the intraoperative discoveries （P 〈 0.05）. Conclusion The MR imaging diagnosis before operation do not correspond to the intraoperative discoveries, indicating that MRI diagnosis fails to make a relatively comprehensive and accurate diagnosis. So it is advisable to make a diagnosis based on clinical symptoms.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2009年第7期800-802,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
脊髓损伤
颈椎管狭窄
MRI
诊断
Spinal cord injury Cervical spinal canal stenosis MR imaging Diagnosis
