脊柱损伤的MRI诊断及其临床意义

目的探讨脊柱损伤的MRI表现及其临床意义。方法对165例资料完整的脊柱损伤病例进行回顾性分析,总结MRI表现特点,并与X-ray、CT片进行对比。结果本组165例中,206个损伤椎体见于117例,58个损伤附件见于38例,无骨折脱位10例,其中同时损伤椎体及附件26例。按照损伤类型分,骨挫伤49个,局部撕脱骨折9个,附件骨折58个,椎体压缩骨折103个,椎体爆裂骨折45个,骨折伴脱位34个,无骨折脱位10个。多椎体损伤25例;椎管狭窄63例;椎间盘损伤104个;韧带损伤114例;椎管内血肿12例。脊髓损伤中,水肿14例,出血8例,挫伤40例,横断11例,受压22例,空洞2例,萎缩1例。结论MRI能全方位地反映脊椎及脊髓损伤的程度和病理变化,对脊髓、椎间盘、韧带及其他软组织的损伤做出评价,是临床诊断、治疗评价和改善预后的最佳检查方法;特别是对X-ray、CT不能发现的骨挫伤,具有重要诊断意义;但对附件骨折还存在一定的局限性。

MRI diagnosis of spinal injury and its clinical significance

Objective To study MRI findings and clinical application of spinal injury.Methods In a retrospective study,165 cases of spinal injury adopted MRI scanner comparing to X-ray and CT.Course of disease,wound types and injury positions were included in the analysis.Results Totally 206 vertebral body and 58 adnexal injury were involved in,49 cases belong to bone contusion,9 and 58 to local avulsion and adnexal fracture respectively,another 103 and 45 to vertebral body compression and blow-out facture,facture with or without dislocation each had 34 and 10 cases,the other 25 cases to multiple vertebral body injury,104 to inter vertebral disc injury and 114 to ligament injury,63 to spinal canal stenosis,12 to intraspinal hematoma.Among spinal cord injury,there were 14 with edema,8 with hemorrhage,40 with contusions,11 with transverse break,22 with compressions,2 with cavities and only 1 with atrophy.Conclusion MRI can reflect spinal and spinal cord injury level and pathologic change of different type complete directively,and evaluate injury of spinal cord,intervertebral disc and other soft tissue like periligament.It still has some limitation in adnexal fracture,but it is an optimal procedure in clinical diagnosis,treatment evaluation and improving prognosis,meanwhile,it has clinical significance,especially to find bone contusion comparison to other imaging examination.