3D MRI在脊柱侧弯畸形矫形术前的临床应用价值  

Preoperational application of 3D MRI in scoliosis patients

作　　者：王丽琴[1] 杨军林[2] 杨智云[1] 周旭辉[1] 李子平[1] 

机构地区：[1]中山大学附属第一医院放射科,广东广州510080 [2]中山大学附属第一医院脊柱外科,广东广州510080

出　　处：《中国介入影像与治疗学》2012年第7期483-486,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：广东省科技计划项目(2008B030301114)

摘　　要：目的探讨3D MRI在脊柱侧弯患者矫形术前的临床应用价值。方法对100例脊柱侧弯患者行术前3DMR检查,采用3D-SPACE T2W序列,多平面重组图像,测量T4、顶椎、L1水平脊髓和椎体的轴位旋转角,观察测量所得顶椎脊髓旋转角与Cobb角的相关性,并进行统计学分析,对顶椎水平脊髓旋转与椎体旋转进行对比。结果顶椎水平脊髓旋转角与Cobb角存在相关性。顶椎水平脊髓旋转可分为3种类型,过度旋转型80例,旋转不足型13例,相反旋转型7例。35例患者最大脊髓旋转角不在顶椎水平。脊髓旋转与椎体旋转不同,在Cobb角大者,大部分脊髓旋转角度大于椎体旋转。MR检查发现2例合并多发神经纤维瘤,1例脊髓空洞,1例蝴蝶椎畸形,5例半椎体并蝴蝶椎畸形,1例合并腹股沟斜疝。结论脊髓、椎体旋转的大小及类型存在差异。脊柱侧弯患者常合并脊髓及椎体多发畸形,3D MR检查在脊柱侧弯畸形矫形术前评估中起着重要作用。Objective To assess preoperational application value of 3D MRI in scoliosis patients. Methods Totally 100 scoliosis patients underwent 3D-SPACE T2W MR imaging. Rotation of the spinal cord in axial section was measured at T4, the apical vertebra and L1 level through MPR. The correlation of rotational data of the spinal cord of apical vertebra and Cobb angle were analyzed, and the degrees of spinal cord and vertebra rotation were compared. Results Statistical analysis showed significant correlation between spinal cord rotation and Cobb angle at apical level. There were three rotation types, i.e. overrotation type （n=80）, under-rotation type （n= 13） and reverse rotation type （n= 7） in apical level. Thirty-five patients had larger cord rotation angle besides apical level. The rotation angle of spinal cord was obviously different from that of vertebra especially in patients with large Cobb angle, and most of them had smaller vertebra rotation than spinal cord. There were 2 multiple nerve fibroma, 1 syringomyelia, 1 butterfly vertebral, 5 half vertebral and butterfly vertebral malformation and 1 indirect hernia in these 100 patients. Conclusion The rotation degree of spinal cord is different from that of vertebra in scoliosis patients. Scoliosis often accompany with multiple deformities of spinal cord and vertebra. And 3D MRI plays an important role in preoperative assess of scoliosis.

关 键 词：脊髓疾病 脊柱侧弯 磁共振成像 脊髓旋转 

分 类 号：R687.3[医药卫生—骨科学] R445.2[医药卫生—外科学]