中央型颈脊髓损伤MRI与临床表现的相关研究

Relative study on the MRI and clinical features of acute central cervical cord injury

目的:观察中央型颈脊髓损伤临床表现和MRI特点,探讨两者之间的相关性。方法:回顾分析56例中央型颈脊髓损伤患者的MRI及临床资料,分析其MRI特点以及脊髓损伤后上下肢AMS评分。结果:脊髓MRI信号改变节段:56例患者中其中C4/5节段17例,C5/6节段10例,C3/4节段8例,C6/7节段6例,多节段脊髓信号改变11例。MRIT2高信号改变52例,低信号改变4例;信号改变范围:单纯灰质区改变6例,脊髓灰质白质联合信号改变50例。脊髓损伤后上下肢AMS评分平均为30.2±1.3、46.4±1.6,上下肢AMS评分之间存在显著性差异(F检验,P<0.05),C3/4节段脊髓损伤屈肘评分平均为8.4,与其他各组相比具有显著性差异(F检验,P<0.05)。结论:中央型脊髓损伤通常导致上肢远端肌肉功能障碍,C3/4节段损伤会影响上肢近端肌肉;MRI信号改变多见于C4/5节段,高信号改变为主,信号改变范围不仅仅局限于脊髓灰质,脊髓灰质、白质联合改变较多。

Objective：To evaluate the relativity between the clinical syndrome and the MRI character of the cervical central cord injury. Methods：Cervical central cord injury patients were treated in our hospital, 56 cases had intact files. All the patients were incisively analyzed the MRI features and scored with American Spinal Injury Association. Results：The abnormal signal locations in the spinal cord were： 17 eases in C4/5, 10 cases in C5/6, 8 eases in G3/4, 6 cases in C6/7 and 11 eases in multiple locations. There were 52 cases with high signal and 4 cases with low signal in T2WI. The ranges of the abnormal signal were： 6 cases in grey matter, 50 cases in both grey and white matter. The average AMS score were 30.2±1.3,46.4±1.6, and there was obviously difference between the arm and the leg of the AMS score （F-test, P 〈 0.05）. The average score of the flexion was 8.4, and there was significantly difference （ P 〈 0.05）. Conclusion：It often resulted in the muscle function disturbance of the distal arms. If the injury was in the C3/4, it would damage the proximal end of the arms. The abnormal signal was often in C4/5, mostly had the high signals in the spinal cord and the range of which were not only in the grey matter but in the grey and white matter.