影像学检查在无骨折脱位型颈脊髓损伤中的临床应用价值

Clinical Value of Imaging Examination in Cervical Spinal Cord Injury without Fracture and Dislocation

无骨折脱位型颈脊髓损伤(CSCIWOFD)是一种特殊类型的脊髓损伤,以颈椎过伸性损伤为主要损伤机制,患者多有颈椎管狭窄、后纵韧带骨化、黄韧带肥厚以及椎间盘突出等基础疾病,导致迟发性颈椎不稳,出现颈脊髓损伤症状加重。普通X片检查不能发现颈椎周围软组织损伤情况,但可反映颈椎管狭窄以及颈椎不稳等病理改变,磁共振成像对软组织有良好的分辨率,可用于评价颈椎软组织的损伤情况,并明确脊髓损伤节段。随着影像技术的不断提高,DTI技术的应用为疾病的精准诊断和预后提供了理论依据。

Cervical spinal cord injury without fracture and dislocation(CSCIWOFD)is a special type of spinal cord injury.Hyperextension injury is the major injury mechanism.Most patients have cervical spinal canal stenosis,ossification of posterior longitudinal ligament,hypertrophy of ligamentum flavum and protrusion of intervertebral disc,which will lead to tardive cervical instability and increase symptoms of cervical spinal cord injury.X-ray could not find soft tissue damage around cervical vertebra.However,it can relfect the pathological changes of cervical spinal stenosis and instability.Because of the high resolution rate of soft tissue,MRI can evaluate soft tissue injury of cervical spine and identify the injury segment of spinal cord.With the continuous improvement of radiological imaging technology,the application of DTI technology provides a theoretical basis for the accurate diagnosis and prognosis.