急性颈椎损伤MRI表现与脊髓损伤的相关性

目的　探讨MRI检查在判断急性颈椎损伤患者脊髓损伤程度中的作用。方法　对 82例急性颈椎损伤患者在受伤 2 4h内行MRI检查 ,并进行早期连续的临床检查 ,分析MRI表现与脊髓损伤程度之间的相关性。结果　急性颈椎损伤的 10种MRI表现中 ,髓内出血提示完全性脊髓损伤 (FrankelA级 ) ;脊髓肿胀及脊髓水肿多见于FrankelA -C级的病人 ,同时 ,脊髓肿胀及水肿的程度与脊髓损伤程度成正比 ;脊髓受压多见于FrankelA级和FrankelB级的患者 ;颈椎脱位多见于脊髓损伤程度较重 (FrankelA -C级 )的患者 ;椎管狭窄与脊髓损伤程度之间无明确相关性 ,但多见于老年患者 ;颈椎间盘突出、颈椎椎体骨折、颈椎附件骨折及韧带损伤与脊髓损伤程度间无明显相关性。结论　急性颈椎损伤患者早期行MRI检查 ,可以帮助判断脊髓损伤的程度 ,对治疗方法的选择及准确判断预后具有重要的指导意义。

Correlation of MR Findings with Degree of Neurologic Deficit in Acute Cervical Spine Trauma

Objective To study the clinical significance of MRI in the evaluation of degree of neurologic deficit in acute cervical spine trauma.Methods Eighty two patients with acute cervical spine trauma took the MR examination during 24 hours after injury.The correlation of MR imaging findings with degree of neurologic deficit was analyzed.Results Among the 10 MR imaging findings,intramedullary hemorrhage was predictive of a complete neurologic lesion(Frankel A),the degrees of cord swelling and cord edema were directly proportional to the severity of injury,spinal cord compression was evident in a large portion of Frankel A and Frankel B injuries,subluxation was found with greater frequency in the most severe injuries(Frankel A and Frankel B),cervical spondylosis was observed more often in the older age groups,and disk herniation,body fracture,posterior element fracture and ligament injury had no correlation with neurologic deficit.Conclusion MR imaging findings can show the degree of neurologic deficit in acute cervical spine trauma,thus it can be helpful in selection of treatment and evaluation of prognosis.