创伤性无骨折脱位型颈脊髓损伤MRI诊断价值.docVIP

创伤性无骨折脱位型颈脊髓损伤MRI诊断价值 　 作者：林焕斌，陈华燕，许孟君 【摘要】 目的 探讨创伤性无骨折脱位型颈脊髓损伤(SCIWFD)的MRI表现及其临床意义。方法 自2000年1月—2006年12月100例颈部外伤患者, 行颈椎X线或CT检查未发现骨折及脱位，MRI检查发现不同程度脊髓损伤，分析颈髓损伤的MRI表现及其与预后的关系。结果 本组100例SCIWFD中，脊髓形态改变包括：脊髓肿胀12例；脊髓受压：颈椎后纵韧带钙化28例，颈椎间盘退变或损伤后突出55例，椎体后缘骨赘23例，黄韧带增生、肥厚或骨化37例；脊髓萎缩9例。脊髓信号改变包括：髓内水肿33例，髓内出血41例，脊髓软化或囊性变18例，脊髓信号无改变8例。结论 MRI可显示SCIWFD致伤的机制及其损伤的程度，并为其治疗方案的选择，预后的判断，提供了十分可靠的科学依据。 【关键词】 颈髓损伤；无骨折脱位；磁共振 【Abstract】 Objective To study the MRI features and its clinic significance of traumatic cervical spinal cord injury without fracture and dislocation (SCIWFD). Methods From Jan. 2000 to Dec. 2006, 100 cases of trauma in cervix without fracture and dislocation were found by X-ray or CT check-up, with diverse cervical spinal cord injury were found by MRI. These injuries were reconfirmed by MRI which was carried through after treatment. The MRI appearances of the injuries and its prognosis were studied. Results The morphological change of spinal cord included: 12 cases of spinal cord swelling.Spinal cord compression which included 28 cases of OPLL in cervical spine, 55 cases of cervical dischernation (degenerative and injuried), 23 cases of hypertrophy in back-edge of cervical spine, and 37 cases of hypertrophy or ossification of ligament.9 cases of spinal cord atrophy. The signal changes of spinal cord in MRI included: 33 cases of spinal cord edema, 41 cases of intraspinal hemorrhages, 18 cases of cystic degeneration of spinal cord and 8 cases of no abnormity of signal in the spinal cord. Conclusion MRI can show the causes and degrees of injuries in the spinal cord in SCIWFD. MRI evaluation provides very reliable scientific foundation for choices of its treatment and the judgment of prognosis. 【Key words】 cervical spinal cord injury; without fracture and dislocation; MRI 颈椎骨折脱位合并脊髓损伤是一种常见的损伤，而受到人们的普遍注意，且报告较多，但创伤引起的无骨折脱位型脊髓损伤（spinal cord injury without fracture and dislocation，简称SCIWFD） 在临床上并不少见，但直到1982年Pang［1］才将其列为脊髓损伤的一种特殊类型，目前国内报告尚不多。随着MRI在脊柱创伤中应用的普及，SCIWFD发现率也不断提高，其早期诊断对治