磁共振脊髓水成像在椎管病变诊断中的应用

目的：探讨磁共振脊髓水成像（MR myelography，MRM）在椎管病变诊断中的临床应用价值。方法：采用西门子Avanto 1．5T超导磁共振成像系统，利用Tim线圈、自动移床及无缝拼接技术对85例疑似脊柱及脊髓病变者分别行常规平扫和MRM．三维图像经最大强度投影及立体透视技术后处理后多角度观察。结果：MRM可清晰显示椎管内“造影柱”的形态。椎管内外不同病变对造影柱造成的压迫各有特征：硬膜外病变会导致患侧造影柱狭窄；硬膜下病变会造成患侧造影柱扩大．脊髓向对侧移位；髓内病变会造成造影柱均匀变窄。结论：MRM具有无创伤、无辐射、速度快、无需对比剂、患者易接受的特点，对各种病变所导致的椎管改变可清晰显示，通过对造影柱形态的观察可对病变进行定位或定性诊断：与常规MRI图像结合可荻得全面、直观的病变信息，可取代X线脊髓造影和CT脊髓造影。

Applications of Magnetic Resonance Myelography in Diagnosis of Canalis Spinalis Disease

Objective To study the values of Magnetic Resonance Myelography for the diagnosis of canalis spinalis disease. Methods Eighty-five patients suspected with Canalis Spinalis disease were detected with Avanto 1.ST MR system（Siemens company） by using different Tim coils, and automatic moving-table and seamless splicing techniques. All the patients underwent conventional MR imaging and MR myelography of vertebral canal. Results MRM could demonstrate the shape of the contrast post. The diseases had different pressing characteristics of the contrast post, and the diseases of epidural space made the contrast post of the diseased side narrow, and the diseases of the subdural space made the contrast post of epidural side enlarged, and the spine cord was moved to the opposite side, and the diseases of the spine cord made the contrast post narrow even. Conclusion MRM is non-invasive, radiationless, fast and has no need for contrast agent, which can demonstrate the change of the spine cord resulting from various kinds diseases of vertebral column. The shape of the contrast post is valuable for determining the location and character of the disease. Combined with routine MRI, MRM can acquire overall and objective information of pathological changes, which can take the place of X-ray myelography and CT myelography.[Chinese Medical Equipment Journal, 2010,31 （4） ：61-63]