实验性急性脊髓损伤MRI特点及与病理相关研究  

MRI Characteristics and Their Correlation with Histopathology of Experimental Acute Spinal Cord Injury

作　　者：严建春[1] 倪才方[2] 丁乙[2] 胡春洪[2] 刘一之[2] 王冬青 

机构地区：[1]镇江市第四人民医院CT室 [2]苏州医学院附属第一医院影像中心,215006

出　　处：《临床放射学杂志》2000年第6期380-383,共4页Journal of Clinical Radiology

摘　　要：目的　研究轻、重两组急性脊髓损伤 (SCI)的MRI特点及MRI信号类型与病理的关系。材料与方法　采用改良Allen’sWD法制成轻、重两组急性SCI模型各 8例 ,对照组 6例。在损伤后第 12小时在 0 .5TMR仪扫描结束后处死取病理标本 ,光镜下观察病理变化。在MRI矢状位最清晰层面上测定T1WI、T2 WI、PDWI损伤区相对信号强度 ,上下径、前后径及损伤区面积并测定犬急性SCI后的神经功能。结果　 ( 1)重级组 ( 5 5 0g/cm)神经功能分级均为A级损伤 ,轻级组 ( 2 5 0g/cm) 3例B级 ,5例为C级 ,而对照组均为E级 ;( 2 )轻、重两组损伤区面积或上下径 ,两者之间均有显著性差异 (P <0 .0 5 ) ;( 3 )轻、重两组脊髓损伤区前后径均高于对照组(P <0 .0 5 ) ,而轻、重两组之间无显著性差异 (P >0 .0 5 ) ;( 4 )T1WI相对信号强度 :轻、重组与对照组三者之间两两比较均无显著性差异 (P >0 .0 5 ) ;T2 WI或PDWI相对信号强度 :轻、重组均高于对照组 (P <0 .0 5 ) ,而轻、重两组之间无显著性差异 (P >0 .0 5 ) ;( 5 )急性SCIMRI信号类型反映了病理变化 ,中场强MRI对脊髓实质水肿及较大出血灶较为敏感 ,而对点状或局灶性出血则显示较差。结论　MRI能显示急性SCI的程度、范围及病理变化 。Objective To study MRI characteristics of mild and severe acute spinal cord injury (ASCI), and to clarify the correlation between MRI signal patterns and histopathologic findings.Materials and Methods Mild group (n=8) and severe group (n=8) of ASCI were produced with a modified Allen's technique. Control group had 6 cases. MRI was performed in 12 hours after the injury. The dogs were killed immediately after MRI and histopathologic exam was made with the light microscope. Relative signal intensity, abnormal signal length, diameter and injured area were measured on the clearest scan in sagittal plane. Functional deficit was assessed and recorded with a modified ASIA classification.Results (1) Functional deficit classification was as follows: severe group (550g/cm) was A scale in all cases; mild group (250g/cm) was B scale (n=3) or C scale (n=5); control group was E scale in all cases. (2) Significant difference in the injured area or longitudinal length was seen between mild group and severe group (P<0.05), but no significant difference in mean injured diameter was seen (P<0.05). (3) No significant difference in the relative signal intensity on T 1WI was seen between the three groups (P>0.05), while on T 2WI or PDWI, the difference was significant (P<0.05) between control group and mild or severe group, but was not significant between mild and severe group (P>0.05). (4) MRI signal patterns reflected pathological changes subsequent to acute spinal cord injury, and was especially sensitive to edema and large bleeding lesion with less sensitive to small and focal hemorrhage of injured spinal cord.Conclusion MRI is very useful in demonstrating the pathological changes of ASCI and is very helpful in assessing the damage and prognosis.

关 键 词：急性脊髓损伤 磁共振成像 病理组织学 动物模型 

分 类 号：R445.2[医药卫生—影像医学与核医学]