摘要
目的:回顾性分析儿童无骨折脱位型脊髓损伤(SCIWORA)的MR影像学表现及临床特点,提高对儿童SCIWORA MRI特征的认识。方法:对2004年4月-2011年10月我院诊断为SCIWORA的10例患儿的临床及脊柱MRI资料进行回顾性分析。结果:10例患儿均于外伤后(车祸碾压腰腹部1例,外力打击腰部2例,舞蹈练习下腰7例),立即至3天后出现下肢无力、疼痛等脊髓损伤症状,10min^3d(中位时间3.5h)后症状达高峰,出现下肢瘫痪,症状稳定不再进展。伤后2~10d行首次脊柱MRI检查,病变累及全脊髓的1例,累及下颈段、胸段、腰段1例,累及胸段者2例,累及胸、腰段的6例。MRI显示脊髓水肿4例,呈长T2长T1信号;脊髓水肿伴出血6例,出血呈短T1信号。11~18d复查者10例,病变范围减小1例,范围增大2例,范围无变化7例。复查时出血者3例。伤后32~42d复查者4例,均发现脊髓萎缩。本组合并非神经性软组织损伤1例,可见前纵韧带损伤。结论:全脊柱MRI检查是用于诊断儿童SCIWORA的最佳影像学检查方法,不仅可进行脊髓损伤的神经影像学评估,还可显示脊柱X线及CT无法直接显示的脊柱韧带、椎间盘、终板及骨髓等非神经性软组织损伤情况,有利于临床治疗方案的制定及预后评估。
Objective：To improve the understanding of MRI features of the spinal cord injury without radiologic ab-normality （SCIWORA）in children,by reviewing the MRI findings and the clinical characteristics of the pediatric SCIWORA respectively.Methods：The clinical data and MR images of ten patients who were diagnosed as SCIWORA from April 2004 to October 2011 were analyzed retrospectively.Results：In 10 cases lower limb weakness,pain and other spinal cord injury symptoms appeared,immediately to the 3rd day after trauma.The symptoms progressed to the peak from 10 min to the 3rd day （median time 3 .5 hours）after trauma,and the lower limbs paralysis was stable.The causes of SCIWORA included the abdominal trauma in the car accident （n= 1 ）,external force hitting on the waist （n= 2 ）and low back inj ury in the dance practice （n= 7）.The first spinal MRI was performed from 2 to 10 days after the trauma.The lesion involved the whole spi-nal cord in 1 case,thoracic segment in 2 cases,lower cervical,thoracic and lumber segments in 1 case,and thoracic and lum-ber segments in 6 cases.MR findings of the injured spinal cord included spinal cord edema in 4 cases with prolonged T1- and T2-signal,spinal cord edema with hemorrhage in 6 cases with high signal on T1-weighted images and low signal on T2-FFE. The first follow-up of spinal MRI was performed for 10 cases from 8 to 11 days after the trauma.The lesion extent in-creased in 2 cases,decreased in 1 case,and had no change in 7 cases.Spinal cord hemorrhage was found in the additional 3 cases by the follow-up MRI.The myelatrophy was found in 4 cases by the follow-up MRI 32-42 days after the trauma.Of 4 cases,extraneural soft tissue injury was identified in 1 case,with anterior longitudinal ligament injury.Conclusion：Whole spinal MRI is the best imaging modality for the diagnosis of the pediatric SCIWORA,by providing the comprehensive ima-ging evaluation of the spinal cord injuries.In addition,whole spinal MRI can also display the extraneural soft tissue injurie
出处
《放射学实践》
北大核心
2015年第8期865-868,共4页
Radiologic Practice
关键词
脊髓损伤
脊柱
儿童
磁共振成像
Spinal cord injury
Children
Magnetic resonance imaging
