MRI观察成人无骨折、脱位型颈髓损伤

目的 分析成人无骨折、脱位颈椎外伤合并颈脊髓损伤的MR表现及其临床意义.方法 收集该病患者38例,入院时均行颈椎X线、CT及MR检查,其中男32例,女6例,年龄24～62岁,平均(42.0±0.4)岁.结果 本组病例X线、CT及MR检查均未见颈椎骨折及脱位.脊髓MRI信号改变包括脊髓信号无改变4例,髓内水肿30例,髓内出血9例,脊髓软化或囊性变4例以及增强后有强化13例.其他MRI表现包括颈椎后纵韧带骨化或颈椎间盘退变或损伤后突出等,为脊髓受压迫的原因.结论 MRI可为无骨折、脱位型颈脊髓损伤患者的诊断与正确治疗提供依据.MRI无信号改变或仅有水肿表现者预后较好,髓内出血或者异常强化者预后较差.

MRI study in adult patients with cervical spinal cord injury without fracture and dislocation

Objective To observe the MRI appearance of cervical spinal cord injury without fracture and dislocation and its clinical significance. Methods Thirty-eight patients (32 males, 6 females, aged 24 to 62, mean age years) of cervical spinal cord injury without fracture and dislocation were enrolled. X-ray, CT and MRI of cervical spine were performed in all patients. Results Fracture and dislocatioin of cervical spine were not detected in all patients with X-ray, CT and MRI. Signal changes of spinal cord in MRI included no signal changes of cervical spinal cord (n=4), spinal cord edema (n=30), intraspinal hemorrhage (n=9), cystic degeneration of spinal cord (n=4) and abnormal enhancement (n=13). Other findings in MRI causing cervical spinal cord compression included OPLL in cervical spine as well as cervical dischernation (degenerative and injured). Conclusion MRI provides reliable evidence for the diagnosis, selection of treatments and judgment of prognosis in patients with cervical spinal cord injury without fracture and dislocation. Patients with minimal cord changes on MRI have the best outcome followed by those without abnormal signal intensity and with cord edema. Patients with parenchymatous hemorrhage and abnormal enhancement on MRI are fare badly.