MRI评估脊柱外伤后脊髓功能损伤的临床价值研究

The Clinical Value of MRI in Evaluating Spinal Cord Function Injury after Spinal Trauma

本研究探讨磁共振成像(MRI)评估脊柱外伤后患者发生脊髓功能损伤的临床价值。选取50例脊柱外伤且发生脊髓功能损伤的患者作为观察组,另选取同期脊柱外科受伤后未发生脊髓功能损伤的30例患者作为对照组,进行磁共振弥散张量成像(DTI)检查。按照脊髓损伤程度将患者分为轻度、中重度两个亚组,对比DTI参数。采用受试者操作特征(ROC)曲线分析各项DTI参数诊断脊柱外伤患者发生脊髓功能损伤的价值。结果显示,观察组患者的表观扩散系数(ADC值)、λ1值、λ2值均显著高于对照组,各向异性分数(FA值)低于对照组(P<0.05);FA值、λ1值、ADC值和λ2值诊断脊髓损伤的AUC值分别为0.885、0.877、0.834和0.733;中重度脊髓损伤患者的ADC值、λ1值、λ2值均显著高于轻度脊髓损伤患者,FA值低于轻度患者(P<0.05)。治疗后,观察组患者的ADC值、λ1值、λ2值均较治疗前显著降低,FA值较治疗前显著升高(P<0.05)。采用MRI的DTI参数评估脊柱外伤患者发生脊髓损伤具有一定的临床价值,还可评估患者治疗前后的功能恢复情况。

This study investigated the clinical value of magnetic resonance imaging(MRI)in assessing spinal cord injury in patients with spinal trauma.Fifty patients with spinal trauma and spinal cord injury were selected as the observation group,and 30 patients without spinal cord injury after spinal surgery injury during the same period were selected as the control group.The magnetic resonance diffusion tensor imaging(DTI)was performed in all patients.According to the degree of spinal cord injury,the patients were divided into mild and moderately severe subgroups to compare the DTI parameters,and the receiver operating curve(ROC)was used to analyze the clinical value of each DTI parameter in diagnosing spinal cord injury in patients with spinal cord injury.The results showed that the apparent diffusion coefficient(ADC)value,λ1 value andλ2 value of the observation group were significantly higher than those of the control group,and the fractional anisotropy(FA)value was lower than that of the control group(P<0.05).The AUC values of FA value,λ1 value,ADC value andλ2 value for the diagnosis of spinal cord injury were 0.885,0.877,0.834 and 0.733,respectively.The ADC value,λ1 value andλ2 value of patients with moderate to severe spinal cord injury were significantly higher than those of patients with mild spinal cord injury,the FA value was lower than that of mild patients(P<0.05).After treatment,the ADC value,λ1 value andλ2 value of the observation group were significantly lower than those before treatment,and the FA value was significantly higher than before treatment(P<0.05).Using MRI DTI parameters to evaluate spinal cord injury in patients with spinal trauma has certain clinical value,and can also evaluate the functional recovery of patients before and after treatment.