晚期脊髓损伤患者许旺细胞移植前后MRI特征及其临床意义

MRI features and clinical significance in patients with chronic spinal cord injury before and after Schwann cell transplantation

为探讨晚期脊髓损伤许旺细胞移植前后MRI特征及其临床意义,回顾性分析38例晚期脊髓损伤患者许旺细胞移植前后的MRI特征,并采用ASIA评分评价神经功能。移植前38例在MRI上均显示脊髓软化囊性变,平均体积为(7.61±9.38)mm3,移植后10例软化囊性变消失,其余28例软化囊性变均有缩小,平均体积缩小至(5.96±7.56)mm3(P<0.05)。移植后脊髓功能均有部分恢复,运动评分由移植前(41.56±16.68)分提高至移植后(44.15±17.14)分(P<0.05);针刺觉评分由移植前(58.85±23.45)分提高至移植后(65.50±23.85)分(P<0.05);轻触觉评分由移植前(56.56±23.43)分提高至移植后(65.75±23.25)分(P<0.05),提示MRI能较好反映许旺细胞移植前后脊髓的形态学特征,脊髓软化囊性变的缩小或消失可作为判断许旺细胞移植成活的一个重要指标。

In order to investigate MRI features and its clinical significance before and after Schwann cell transplantation in patients with chronic spinal cord injury,the experiment retrospectively analyzed the MRI features of 38 patients with chronic spinal cord injury before and after Schwann cell transplantation,and assessed their nerve function by using American Spinal Injury Association（ASIA）classification.All patients showed myelomalacia and cystic degeneration before Schwann cell transplantation,and their average volume was（7.61±9.38）mm3.But after Schwann cell transplantation,myelomalacia and cystic degeneration disappeared in 10 patients.Other 28 patients showed the volume turned to small,the average volume reduce to（5.96±7.56）mm3（P〈0.05）.At the same times,never function was partly improved in all patients.The ASIA grade of motor function was increased from 41.56±16.68 to 44.15±17.14（P〈0.05）,the ASIA grade of pin prick was increased from 58.85±23.45 to 65.50±23.85（P〈0.05）,the ASIA grade of light touch was increased from 56.56±23.43 to 65.75±23.25（P〈0.05）.The results suggested that MRI could well reflex morphological characteristics of spinal cord before and after Schwann cell transplantation in patients with spinal cord injury.The reduction or disappearance of myelomalacia and cystic degeneration could be regarded as a very important index of Schwann cell survival.