急性脊柱创伤的影像学分析

Comprehensive analysis of imaging in acute trauma of spine

目的 :探讨各种影像检查对急性脊柱创伤的诊断价值及限度。方法 :回顾性分析 2 5 2例急性脊柱创伤病例 ,均在伤后 48h内行X线平片、CT及MRI检查。结果 :共检出椎体骨折 2 78例 ,X线平片、CT及MRI检出率相同 ,三者对附件骨折的检出率分别为 9.1%、2 3 .4%、14 .3 %,差异有极显著性意义 (P <0 .0 1)。 15 2例MRI直接显示脊髓损伤。结论 :在急性脊柱创伤的影像诊断中 ,X线平片可作初检手段 ,CT对骨折检出率最高 ,MRI对脊髓损伤诊断最佳 ,三者结合可提高诊断水平。

Objective:To study the value and limitation of various imaging methods in diagnosis of acute trauma of spine.Methods:252 cases with acute trauma of spine were performed radiography,CT and MRI 48 hours after trauma.The imaging findings were retrospectively analyzed.Results:In all cases 278 parts of the fractures of the vertebral body were detected,and the detectability of plain film,CT and MRI was the same in the demonstration of the fracture of vertebral body.The fracture detection rate of the appendage by plain film,CT and MRI,however,was 9.1%,23.4% and 14.3%,respectively,and the difference was statistically significant.152 cases showed spinal cord injury on MRI.Conclusion:In acute trauma of spine plain film is the first step of choice for screening.The fracture detection rate of CT is highest in the above imaging methods mentioned.MRI is the best of diagnosing spinal cord injury.The combined use of the three imaging methods may improve the diagnosis.