MRI在急性脊柱外伤诊断中的应用价值

Application value of MRI for diagnosis of acute spinal injuries

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。

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.