MRI影像对颈椎小关节脱位伴脊髓损伤的评估价值  

Value of MRI in the evaluation of cervical spinal dislocation with spinal cord injury

作　　者：苏琦[1] 任先军[1] 蒲渝[1] 邓天琼[1] 孙其志[1] 

机构地区：[1]解放军第三军医大学新桥医院骨科,重庆市400037

出　　处：《中国临床康复》2005年第41期60-62,i0002,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:了解颈椎小关节脱位后MRI表现与脊髓病理变化之间的关系。方法:实验于2003-10／2004-03在第三军医大学新桥医院实验动物中心和野战外科研究所完成。在14只成年健康杂种犬颈椎上经手术及 BIM-Ⅱ型对撞机撞击,造成犬颈椎小关节脱位模型。颈椎MRI检查后取颈椎损伤及损伤上下节段脊髓标本,将C2-3段脊髓作为正常对照组, C5-6段脊髓作为损伤组,行光镜、电镜检查。比较颈椎小关节脱位后MRI 表现与脊髓病理变化。结果:14只犬中9只成功制成颈椎小关节脱位模型,进入结果分析。①犬损伤脊髓的MRI表现:MRI显示损伤段脊髓肿胀,7例T1加权信号不均匀,T2加权呈以斑片状高信号为主的混杂信号。②两组犬脊髓的病理观察结果:损伤脊髓广泛出血,水肿,部分神经元坏死。2例T2加权显示局部呈稍高信号,病理示中央区见灰质局部点状出血,脊髓水肿。结论:MRI能够反应脊髓的损伤程度,对出血、实质水肿等病变敏感,但不能显示脊髓损伤过程中细胞变性、炎性细胞浸润等病理变化。AIM： To investigate the correlation between MRI manifestations and pathological changes of spinal cord after cervical spinal dislocation. METHODS： The experiment was carried out in the experimental animal center of Xinqiao Hospital and Institute of Field Surgery of the Third Military Medical University of Chinese PLA between October 2003 and March 2004. Fourteen healthy canines were made into models of cervical spine dislocation by operation and struck with BIM-Ⅱ striker. After cervical MRI examination, samples of cervical injury and upper and inferior segment of injured spinal cord were removed, the C2-3 spinal cords were taken as the normal control group, and C5-6 spinal cords as the injury group, and then the examinations of light microscope and electron mleroscope were conducted. The MRI manifestations and pathological changes of spinal cords after cervical spinal dislocation were compared. RESULTS： Of the 14 canines, 9 were successfully made into models of cervical spinal facet dislocation, and entered into the analysis of results. ① MRI manifestations of injured spinal cord in canines： MRI showed that the cervical spinal cord swelled, T1 weight signal was unequal, and T2 weight showed mixed signal manifested mainly by spotty high signal in 7 cases. ② Pathological observation of spinal cord in the canines： hemorrhage and edema occurred extensively in the injured spinal cord, necrosis was observed in part of neurons. 2 cases showed local higher single of T2 weight on MRI, and pathology revealed hemorrhage in the white matter, edema in white matter and gray matter. CONCLUSION： MRI can reflect the severity of spinal injury, it is sensitive to the lesions of hemorrhage and edema, but it cannot show the pathological changes of nerve cell degeneration and inflammatory cell infiltration.

关 键 词：颈椎 脱位 脊髓损伤 磁共振成像 

分 类 号：R681.53[医药卫生—骨科学] R445.2[医药卫生—外科学]