急性颈椎外伤的MRI诊断

目的 分析急性颈椎外伤的MRI征象，评价MRI在急性颈椎外伤诊断中的价值及限度。方法收集急性颈椎外伤150例，均有MRI检查和X线平片，15例有CT片，采用14个参数进行分析记录。结果150例中MRI检出骨折51个，小关节脱位30个，椎体脱位35个；外伤性椎间盘突出40个，硬膜外血肿2例；脊髓损伤69例；脊髓受压迫20例；前、后纵韧带损伤21例；棘间韧带和黄韧带损伤15例；椎前血肿或水肿30例；椎旁和背侧软组织损伤40例；X线平片发现椎体骨折55个，椎体脱位35个；小关节脱位35例，附件骨折25个，椎前软组织肿胀20例。15例CT均发现骨折，小关节脱位，椎管狭窄。结论MRI在显示脊髓、韧带、椎间盘和软组织损伤方面优于CT和X线平片。MRI能全面反映颈椎各种损伤的病理特征，为评估颈椎稳定性提供充分的依据；MRI和X线片的骨折检出率没有明显差异，CT应该用于复杂的颈椎骨折检查。

Diagnosis of acute cervical spine trauma with MRI

Objective to analyse MRI features of acute cerv ical spine trauma (ACST)and evaluate the values and limitations of MRI in diagnosing ACST.Methods 150cases of ACST underwent MRI and X -ray examinations.15cases of them had also CT films.14pa-rameters were designed to evaluate ACST by two experienced radiologists.Results Numbers of abnormalities depicted b y MRI were as fol-lows:cervical vertebral body fracture 51,traumatic disk herniation 40,facet dislocation 30,vertebral body dislocation 35,epidural hematom a2,cord injury 69,cord compression 20,anterior and posterior longitudi nal ligament injury 21,interspinal ligament injury 15,prevertebral injury 30,paravertebral injury 40.Numbers of abnormalitis depicted by X -ray films were as follows:vertebr al body fracture 55,vertebral body dislocation 35,facet dislocat ion 40,soft tissue edema 20.Vertebr al fracture,facet dislocation and c anal stenosis were found in all 15CT examinations.Conclusion MRI was superior to CT and X -ray film i n detecting injuries of spinal cord,ligament,disk and soft tissue.MRI provides sufficient informations f or evaluation of spinal stability.H owever,MRI was not significantly di fferent from X -ray film in detection rate of vertebral body fractures.CT should be reserved for patients with complex fractures.[