颈段椎间盘损伤的MRI评价  

The MRI evaluation of cervical intervertebral disc injury

作　　者：叶彩林 陆璐[2] 陶福媛 余永强[2] 钱银锋[2] 

机构地区：[1]南京医科大学附属儿童医院超声科,江苏南京210008 [2]安徽医科大学第一附属医院放射科

出　　处：《实用放射学杂志》2016年第11期1676-1680,共5页Journal of Practical Radiology

摘　　要：目的探讨MRI评价颈部外伤患者椎间盘损伤及伴发损伤的能力，及其与临床预后的关系。方法回腴性分析194例椎间盘损伤的颈部外伤患者的MRI表现，将椎间盘损伤分为外伤性突出和破裂2组，记录并比较2组间脊髓损伤、椎体骨折、椎旁血肿、韧带损伤以及椎动脉损伤的发生率。根据患者出院时的临床恢复情况将预后分为完全恢复、明显好转、好转、无变化、恶化5个等级，比较不同程度椎间盘损伤对预后的影响。结果194例椎间盘损伤的颈部外伤患者中，椎间盘突出117例共234个，椎间盘破裂77例共92个。椎间盘突出和椎间盘破裂组，脊髓水肿伴出血的发生率分别为21．4％和39．0％，椎动脉损伤的发生率分别为15．4％和35．1％，均存在显著统计学差异（P〈O．01）；脊髓水肿的发生率分别为52．1％和61．0％，2组间无统计学差异（P〉O．01）。椎间盘突出组椎体骨折、椎旁血肿和韧带损伤的发生率分别为63．2％、59．0％和86．3％，椎间盘破裂组均为100％，2组间差异显著（P〈O．01）。出院时，89．7％的椎间盘突出患者临床症状有所恢复，椎间盘破裂组仅26．0％的患者有所恢复，2组间存在统计学差异（P〈O．01）。结论MRI能清晰显示颈部外伤患者的椎间盘损伤及伴发损伤情况，并可根据其MRI表现评估患者临床预后。Objective To explore the ability of MRI in evaluating the cervical intervertebral disc trauma and the associated dama- ges, and its relationship with prognosis. Methods MR imaging of 194 cases with varying degrees of cervical intervertebral disc trau- ma were analyzed retrospectively. Disc injury was classified into disc herniation and disc rupture groups. The incidences of spinal cord injury, vertebral fractures, paraspinal hematoma, ligament damage and vertebral artery injury were recorded and compared between two groups. According to clinic status when patients out of the hospital, the clinical outcomes were classified as five levels： fully restored, significantly improved, improved, unchanged and deterioration, which were compared between two groups. Results A- mong 194 cervical intervertebral disc trauma patients, there were 234 disc herniation in 117 cases and 92 disc rupture in 77 cases. In disc herniation group and disc rupture group, the incidences of spinal cord edema and hemorrhage were 21.4% and 39.0% respec- tively, the incidences of vertebral artery injury were 15.4% and 35.1% respectively, there was significant difference between two groups（P〈0.01}; The incidences of spinal cord edema were 52. 1% and 61.0 % respectively, there was no significant difference between two groups（P〉0.01 }. The incidences of vertebral fractures, paraspinal hematoma, ligament damage were 63.2 % , 59.0 % and 86.3% in disc herniation group, which were 100% in disc rupture group, the difference was significant between two groups（P〈0.01）. When patients out of hospital, various degree recovery was seen in 89.7%cases with disc herniation, which was only 26.0 % in disc rupture group, the difference was significant（P〈0.01）. Conclusion MRI can clearly show the cervical disc trauma and the associated damages, and assess the patient＇s prognosis.

关 键 词：颈部 椎间盘 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]