慢性脊髓创伤的MRI表现

目的　探讨慢性脊髓损伤的MRI表现及其形成机制。材料与方法　分析 2 8例慢性脊髓损伤者的MRI表现及临床资料 ,其中男 2 1例 ,女 7例 ,平均年龄 39岁。伤后行MRI复查时间为 1个月～ 12年。MRI取常规SE序列T1WI、T2 WI矢状、横断面。结果　 2 8例中有 16例发生在颈髓 ,上胸髓及脊髓圆锥各 6例。其中脊髓囊变 13例 ;慢性脊髓受压 5例 ,均合并有其他类型的病理改变 ;脊髓软化 4例 ;脊髓空洞 2例 ;脊髓萎缩 3例 ;脊髓栓系 1例。结论　慢性脊髓损伤分别表现为脊髓囊变、空洞、萎缩、软化、栓系及慢性受压 6种病变 ,脊髓囊变与脊髓瞬间压迫伤有关 ,其病变局限。脊髓空洞及脊髓萎缩均与脊髓持续受压有关 ,病变潜在进展。脊髓软化可能由伤后脊髓缺血引起 ,脊髓栓系是伤后蛛网膜粘连造成

MRI Features of Chronic Spinal Cord Injury

Objective To describe MRI findings of chronic spinal cord injury and to study its possible mechanisms.Materials and Methods MRI findings of chronic spinal cord injury in 28 patients (21 males and 7 females with a mean age of 39 years) were analyzed. MR scan was carried out 1 month to 12 years after injury. MRI was obtained with a 0.35T permanent MR scanner using SE T 1 and T 2WI in both axial and sagittal planes.Results Of 28 patients with chronic spinal cord injuries, the lesion was located at cervical cord or cervico thoracic junction in 16, at thoracic cord in 6 and at medullary cone in 6; while cystic degeneration was seen in 13, chronic compression in 5, malacia in 4, syringomyelia in 2, atrophy in 3 and cord tethering in 1.Conclusion Chronic spinal cord injury has the following 6 manifestations on MRI: cystic degeneration, syringomyelia, atrophy, malacia, tethering and chronic compression. Cystic degeneration is related to original cord trauma caused by vertebral body dislocation in one accident. These lesions are stable with relatively good prognosis. Syringomyelia and atrophy are associated with chronic persistent compression to the spinal cord. These lesions are potentially progressive with a bad prognosis. Cord malacia is caused by ischemia and cord tethering by arachnoid adhesion secondary to spinal surgery.