MRI在急性脊柱外伤诊断中的应用价值(1)
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[摘要] 目的：探讨脊柱MRI在急性脊柱外伤诊断中的应用价值。方法：73例脊柱外伤患者可疑损伤部位采用CT平扫，所有患者于伤后8 h采用自旋回波T1WI、T2WI横断面，T2WI及脂肪抑制STIR序列矢状面行脊柱常规MRI扫描检查。就MRI对脊柱、脊髓损伤的诊断价值进行探讨。结果：73例脊柱外伤患者中，经CT扫描颈椎椎体有骨折块移位及椎管狭窄18例，胸椎椎体7例，腰椎椎体及附件46例，骶椎2例。脊椎骨折73例中有83个椎体骨折。脊髓损伤MRI 检查的检出率为32.88%(24/73)明显高于 CT 检出率13.70%(10/73)，差异有统计学意义(χ2=7.515，P<0.05)。韧带损伤MRI 的检出率63.01%(46/73)明显高于CT 检出率5.48%(4/73)，差异有统计学意义(χ2=53.655，P<0.05)。结论：MRI为非创伤性的脊髓损伤检查方法，准确有效，可为临床确定治疗方案提供依据。
[关键词] 脊柱；外伤；磁共振成像
[中图分类号] R445.2[文献标识码] B [文章编号]1673-7210(2011)08(a)-094-02
Application value of MRI for diagnosis of acute spinal injuries
LIU Chaohui, CHEN Yingfeng
Department of Radiology, the People's Hospital of Taishan City, Guangdong Province, Taishan 529200, China
[Abstract] Objective: To study the application value of MRI for diagnosis of acute spinal injuries. Methods: Plain CT scanned on suspect injury location of 73 cases of spinal injury patients, all the patients took spin-echo T1WI, T2WI cross-section, T2WI and conventional spinal MRI scan on sagittal plane of STIR sequence 8 h after injury. And study the diagnosis value of MRI for spinal column and spinal cord injury. Results: Among the 73 cases of spinal injury patients, 18 cases of fracture fragment displacement on cervical vertebral body and spinal canal stenosis, 7 cases of thoracic vertebral bodies, 46 cases of lumbar and appurtenance, 2 cases of sacral vertebra were found by CT scan. There were 83 lumbar vertebral fractures in 73 cases of vertebral fracture. MRI detection rate of spinal cord injury was 32.88% (24/73) which was obviously higher than CT detection rate 13.70% (10/73), the difference had statistical significance (χ2=7.515, P<0.05). Detection rate of ligament trauma was 63.01% (46/73) which was obviously higher than CT detection rate 5.48% (4/73), the difference had statistical significance(χ2=53.655, P<0.05). Conclusion: MRI is a non-traumatic examine method for spinal cord injury which is accurate and effective so that it provides basis for determining treatment.
[Key words] Spinal column; Injury; MRI
脊柱外伤是骨科临床中的常见病，主要病因为坠落物砸伤和坠落伤，应力分别向下和向上传导，至胸腰段时因结构的原因，造成应力集中而产生骨折[1] ......
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