摘要
目的 探讨椎管内注入Gd DTPA磁共振造影术的临床应用价值。方法 4 1患者造影术前术后均常规自旋回波矢状和轴位扫描 ,2 2例术前行水成像脊髓造影术 ,10例术后行T2 WI矢状扫描 ,9例术后行脂肪抑制自旋回波扫描。腰穿注药量 1~ 2ml,注药后间隔扫描时间为 1/ 2~ 1h(n =8)、1~ 2h(n =2 3)、2~ 5h(n =10 ) ,5例 10~ 32h内造影术后第 2次重复扫描。依据Gd DTPA与脑脊液混合均匀程度、信号强度和弥散范围分为图像一般和图像良好两类。结果 造影术显示脊髓损伤坏死液化灶与脑脊液相通 3例 ,脑脊液外漏 3例 ,蛛网膜下腔阻塞 6例 ,骶管囊肿与脑脊液相通 2例。注药后 1h内复查 ,图像良好 3例 ;2~ 5h复查 ,图像良好 33例。 3例出现轻度头痛、头晕及恶心。结论 该方法是一种安全、有价值的检查技术 ,它集常规MR检查、X线脊髓造影和CTM的优点 。
Objective To evaluate the clinical application of enhanced MR myelography by intrathecal injection of Gd DTPA. Methods Conventional spin echo sagittal and axial MR were performed on all 41 patients pro and post GD injection, myelography was done on 10 cases before injecting GD, fat suppression spin echo T 1W sequence was performed on 9 cases after GD administration. Via lumbar puncture 1~2 ml was injected into the lumbar subarachnoid. The examination was performed at 0 5~1 h ( n =8),1~2 h( n =23),2~5 h( n =10) intervals following GD injection. The same examination was repeated on 5 cases at 10~32 h( n =5) intervals. The MR images of all cases were divided into two sorts:moderate quality and high quality according to the degree of GD mixing with CSF?the signal intensity of CSF and extension of GD scattered in CSF. Results The post GD injected images demostrated CSF of the following information:connecting with intraspinal injury cyst( n =3), traumatic CSF leaks( n =3), complete obstruction of the flow of GD as a result of extradural mass and spinal injury( n =6) and communication between CSF and sacral canal cyst( n =2). Three images were showed high quality at 0 5~1 h and thirty three high quality images at 2~5 h intervals after GD injection.Three patients had mild headache,dizzy and nausea. Conclusion This is a safe, feasibe and valuable technique. Some pathological changes, which is not visible in conventional MRI could be showed on the images, such as CSF connection with intraspinal injury cyst, CSF obstruction, leaks and flow dynamics.
出处
《临床骨科杂志》
2002年第2期106-108,共3页
Journal of Clinical Orthopaedics
关键词
磁共振成像
脊髓疾病
脊柱疾病
magnetic resonance imaging
spinal cord diseases
spinal diseases