胸腰椎骨折后纵韧带损伤的MR影像特点

The MRI characteristics of the posterior longitudinal ligament injury after thoracolumbar fracture

[目的]探讨胸腰椎骨折后纵韧带损伤的MR影像学特点及其临床应用价值。[方法]2010年6月∽2014年6月107例胸腰椎骨折患者术前行CT及MR检查,对后纵韧带损伤的MR图像特征分析并对损伤程度分级,对有椎板减压指征者后路手术探查后纵韧带损伤情况,并将不同MR分级与术中探查进行比较验证,采用Kappa检验统计分析两者间的一致性。[结果]MR检查可显示后纵韧带损伤及程度,将损伤程度分为三级,MR分级与手术探查情况有极好的一致性。[结论]MR检查是明确后纵韧带损伤程度的敏感检查技术,后纵韧带损伤的MR分级将有助全面评价胸腰椎损伤特别是中柱损伤情况,对胸腰椎损伤的治疗有指导意义。

[Objective]To investigate the MRI characteristics of the posterior longitudinal ligament（ PLL） injury after thoracolumbar fracture and its significance in clinical application. [Method]From April 2010 to April 2014,107 patients with thoracolumbar fracture were included into this study. PLL MR images taken from these patients were summarized and analyzed to grade severity of PLL injury. Of them,34 patients who underwent operative treatment were selected to verify the consistency of the grade of PLL injury. Kappa test was used to statistically analyze the consistency between the grade of PLL injury severity and the surgical findings. [Result]MRI might definitively showed extent of PLL injuries which could be classified into 3 grades. The statistical results showed that the consistency of the MRI grade of PLL injury and intraoperative findings was excellent. [Conclusion]MRI is sensitive in judging the degree of the posterior longitudinal ligament injury. Furthermore,the MRI grade of the posterior longitudinal ligament injury is helpful in comprehensively evaluating thoracolumbar injury,especially the middle column injury,which may be significant to proper decision making for treatment of thoracolumbar fractures.