老年慢性挥鞭性翼状韧带损伤的磁共振研究(英文)

目的：探讨老年慢性挥鞭性翼状韧带损伤的影像学特点，为因翼状韧带损伤造成老年长期头颈部疼痛提 供有效的检查手段。方法：选取134 例长期从事挥鞭性运动或工作并患有长期头颈部疼痛的老年患者，对患者进行 常规全面体检( 包括CT，MR，超声，实验室检验) 和3.0T 磁共振质子密度加权像(proton density-weighted imaging， PDWI)，根据常规全面体检结果将患者分为病因明确组(CE 组) 和病因不明组(UE 组)，对两种的PDWI 影像学特 点进行分析。结果：磁共振PDWI 能够清晰显示翼状韧带的解剖结构及信号改变特点，斜冠位能够有效显示翼状韧 带挥鞭性损伤的全貌。在CE 组，96 例患者中7 例韧带损伤征阳性；在UE 组38 例患者中21 例韧带损伤征阳性。有 15.7% 的长期头颈痛患者被证实源于慢性挥鞭性翼状韧带损伤。结论：挥鞭性翼状韧带损伤是造成老年长期头颈部疼 痛的重要原因，高分辨率PDWI 是评价翼状韧带的有效方法，能对因翼状韧带挥鞭性损伤造成的慢性头颈部疼痛作 出准确诊断。

MR investigation in evaluation of chronic whiplash alar ligament injury in elderly patients

Objective: To observe the imaging features for chronic whiplash alar ligament injury in elderly patients and to provide an eff ective diagnostic method for long-term neck pain and headaches due to alar ligament injury in elderly patients. Methods: A total of 134 elderly patients, who engaged in the work or activities related to whiplash motion and suffered from chronic neck pain, were enrolled for the study. All patients were performed comprehensive health examination (CT, MR, ultrasound and laboratory examination) and high resolution PDWI. The patients were divided into 2 groups according to the results of comprehensive health examination: a clear etiology group(CE group, n=96) and an unknown etiology group(UE group, n=38). Th e characteristics of PDWI signal in the ligament were analyzed between the 2 groups. Results: Th e anatomy and signal characteristics of the alar ligament were clearly displayed by high resolution PDWI. Th e alar ligaments were eff ectively displayed by oblique coronal image. In the CE group, 7 patients (7/96) showed the positive sign of ligament injured, while 21 (21/38) patients showed positive sign of ligament injured in the UE group (P<0.01). Chronic whiplash ligament injury was proved to be the reason for long-term neck pain and headaches in 15.7% patients. Conclusion: Th e whiplash injury of alar ligament is an important reason for chronic neck pain in elderly patients. High resolution PDWI is an eff ective method to evaluate the image features of alar ligament and can provide an accurate diagnosis for chronic neck pain and headaches caused by the alar ligament whiplash injury.