X线平片阴性的脊柱外伤MR检查的价值研究

A Study of MR Diagnosis of PF Negative Spinal Traumas

目的探讨MR对X线平片检查阴性的脊柱外伤的诊断价值。方法对103例经X线平片检查结果提示阴性的脊柱外伤病人行脊柱MRI检查,观察椎体附件、椎间盘、韧带、脊髓、神经根、肌肉软组织的形态、信号改变。结果 103例患者MRI检查发现异常31例,阳性率30%,表现为:椎体信号异常45个椎体,T1WI信号减低、T2WI信号增高、STIR序列信号更高;椎间盘损伤9个;前纵韧带损伤6处;后纵韧带损伤8处;发现脊髓损伤5例;一侧神经根损伤1例;椎旁软组织损伤17例。追踪观察7例,MRI提示椎体骨挫伤但无压缩、且未经治疗的患者,复查提示5例搓伤椎体压缩。结论 MRI能显示平片不能观察到的骨挫伤、椎间盘、脊髓、神经根、韧带、软组织损伤,对于X线平片阴性的脊柱外伤患者,应进一步行MRI检查。

Objective To explore the MR diagnostic value of PF negative spinal traumas.Methods Observing the structure and signal changes of the spinal colum appendix,intervertebral discs,ligaments,spinal cords,spinal nerve roots,muscle soft tissues in the light of the MR diagnosis of spinal columns of the 103 cases of patients with the PF negative spinal traumas.Results Among the 103 cases of patients,there were 31 abnormal ones with the positive rate of 30 percent,in which 45 vertebrae the T1WI siginal intensity decreased,T2WI siginal intensity increased and higher STIR siginal intensity,9 cases of intervertebral discs injury,6 cases of anterior longitudinal ligament injury,8 cases of posterior longitudinal ligament injury,5 cases of spinal cord injury,one case of lateral nerve root damage,17 cases of attaching centrum soft tissue damage,5 cases of reviewed-and-ascertained contusive vertebral compression among the 7 cases of tracked and untreated patients illustrated by MRI with centrum bruizes,but no compression.Conclusion MRI can show the bone bruizes,the spinal cord injuries,intervertebral disk injuries,the spinal nerve root damages,the ligament injuries and the attaching centrum soft tissue damages,which cannot be displayed by PF;and MRI is a necessity for further examination of broken spinal columns of the PF negative patients.