磁共振扩散加权成像在急性脊髓损伤中的初步临床应用

Diffusion-weighted magnetic resonance imaging for acute trauma of the spine cord

目的:研究磁共振扩散加权成像(DWI)在急性脊髓损伤诊断中的临床应用价值。方法:急性脊髓损伤患者16例均在遭受外伤72 h内行常规磁共振(MRI)和DWI检查(1.5T MR),DWI采用单次激发平面回波DWI(ssh-EPI-DWI)技术。结果:16例患者中,6例常规MRI阴性(未见明确异常征象),10例常规MRI阳性,阳性均显示为脊髓局灶性异常信号。阳性组按照损伤程度和DWI表现不同分为2型。(1)水肿型:7例,病灶以水肿为主,DWI呈不同程度高信号;(2)混合型∶3例,病灶混合出血与水肿,DWI呈混杂信号。损伤部位较邻近正常部位ADC值有明显减低(t=-7.719,P<0.01)。结论:ssh-EPI-DWI在脊髓外伤的超早期诊断、了解脊髓传导功能的完整性和判断脊髓损伤的程度等方面具有较高的临床应用价值。

Objective To determine the clinical value of diffusion-weighted magnetic resonance imaging（DWI） for acute trauma of the spinal cord.Methods Sixteen patients with acute trauma of the spinal cord were examined with routine magnetic resonance imamging（MRI） and ssh-EPI-DWI,on a 1.5-tesla MR system within 72 h trauma.Results All the 16 patients were examined by MRI and ssh-EPI-DWI： 6 patients were negative and 10 were positive in MRI,which showed local lesions with significant abnormality.Positive cases were classified into 2 categories depending on different degrees of tissue injury and characteristics of DWI.（1） Edema-type： 7 presented DWI high signals with different degrees in local lesions.（2）Mixed-type： 3 showed DWI heterogeneous high signals due to hemorrhage and edema in the lesions.There was significant difference in ADC values between the lesions and normal parts（t=-7.719,P0.01）.Conclusion ssh-EPI-DWI of the spinal cord may provide satisfactory images and is a useful method for visualizing the injury in the superearly stage,helpful to determine the integrity and compression degree of the spinal cord.