颈椎前纵韧带断裂的早期MRI评估  

Early Evaluation of Cervical Anterior Longitudinal Ligament Rupture by MRI

作　　者：李开成[1] 谢幼专[2] 余强[1] 郑连洲[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院放射科 [2]上海交通大学医学院附属第九人民医院骨科

出　　处：《中国医学计算机成像杂志》2011年第4期352-355,共4页Chinese Computed Medical Imaging

摘　　要：目的：探讨急性颈椎创伤中前纵韧带断裂的早期MRI诊断。方法：经手术证实有43处前纵韧带断裂的25例急性颈椎外伤患者纳入研究，男21例，女4例，年龄35～75岁，平均54岁。采用1．5T磁共振成像仪，完成矢状面T1WI（FSE）、T2WI（FRFSE）和脂肪抑制（STIR）成像，层厚3～4mm。2名高级职称医师共同在线阅读MRI图像，以手术结果为参照、回顾性分析前纵韧带断裂及其前后相邻结构的MRI表现。结果：MRI共显示25例30个（30／43，69．8％，其中5例各见2个）颈椎前纵韧带断裂平面，其中25个显示韧带完全断裂，矢状位上连续2—3个层面表现为粗线状异常信号改变，5个显示不完全断裂，矢状位上仅一个层面上表现为细线状或斑点状异常信号改变，异常信号表现为T1WI上等信号、T2WI上高信号、STIR上高信号。23例（23／25，92％）伴有椎前筋膜出血水肿，全部伴有椎间盘损伤（100％），4例患者（16％）见5处椎体前缘撕脱骨折或骨赘骨折，21例（84％）表现颈椎不稳。结论：急性颈椎创伤MRI早期检查有助于前纵韧带断裂的诊断，同时可以发现伴发改变。Purpose： To discuss early magnetic resonance imaging （MRI） findings in cervical anterior longitudinal ligament（ALL） rupture. Methods： A total of 25 patients（21 males and 4 females, aged 35- 75 years, mean 54 years） with cervical trauma were included in our study, 43 spots of rupture in cervical ALL were surgically confirmed. GE 1.5T superconducting MR scanner was used. The sequences included sagittal T1WI, T2WI and STIR. Retrospectively analysis of MRI images about ALL and its adjacent structures was done by two senior doctors, surgical findings were referred. Results： Of 43 spots rupture in cervical ALL proved by surgery, 30 spots were confirmed on MRI with abnormal signal alteration（69.8% ） . Complete rupture was shown as a thick linear intermediate signal on T1 - weighted imaging and high signal intensity on T2 - weighted imaging or STIR imaging, partial rupture was shown as a thin linear or speckled intermediate signal on T1 - weighted imaging and high signal intensity on T2 - weighted imaging or STIR imaging. Twenty - three of 25 patients were proved prevertebral fascia hemorrhage and edema （92%） .All patients existed disc herniation（ 100% ）, 4 patients（ 16% ） existed five avulsed fracture or osteophytic fracture of the front cervical vetebral, 21 patients showed spondylotic instability（84% ）. Conclusion： MRI findings in early phase were valuable for the evaluation of ALL in acute cervical trauma.

关 键 词：颈椎 前纵韧带 断裂 磁共振成像 

分 类 号：R687.3[医药卫生—骨科学]