脊柱创伤患者CT与MRI影像学表现特点分析  

CT and MRI Findings of Patients with Spinal Trauma

作　　者：李道选[1] 王伟[1] 李俊明[1] 马广辉 LI Dao-xuan;WANG Wei;LI Jun-ming(Department of Orthopedics,The Second Affiliated Hospital of Luohe Medical College,Luohe 462300,Henan Province,China)

机构地区：[1]漯河医学高等专科学校第二附属医院骨科,河南漯河462300

出　　处：《中国CT和MRI杂志》2020年第12期155-157,共3页Chinese Journal of CT and MRI

摘　　要：目的分析并总结脊柱创伤患者计算机断层扫描(computed tomography,CT)与磁共振成像(magnetic resonance imaging,MRI)影像学表现特点。方法选取我院62例脊柱创伤患者,均行CT与MRI检查,观察并比较CT与MRI征象及相应检出情况。结果CT碎骨片检出数显著多于MRI(P<0.05),MRI脊椎骨折以及韧带损伤检出率显著高于CT(P<0.05)。CT共检出56例脊椎骨折,表现为椎体变形或椎体楔形压缩改变,其余为2例颈椎滑脱,4例未见明显骨折征象;27个椎管容积改变主要为椎管狭窄以及椎管被碎骨片占领等表现;韧带损伤具有前、后纵韧带明显增厚表现,无法清晰显示断裂情况。MRI检出62例脊椎骨折,具有后缘碎骨片向着椎管位移、椎体之中呈T2WI高信号及T1WI低信号或者等信号表现;发现27个椎管容积改变,表现与CT一致;韧带损伤具有韧带增粗、T2WI呈条状或者呈片状高信号、T1WI间断低信号表现,同时损伤高信号处和邻近组织分界显示不清;椎旁软组织损伤具有T2WI斑片状高信号以及T1WI低信号表现。结论CT可清晰显示脊柱创伤患者碎骨片移位情况,MRI则在检出脊椎骨折以及韧带损伤方面更显优势,临床可根据患者病情合理应用这两种影像学检查手段。Objective To observe the imaging findings of computed tomography(CT)and magnetic resonance imaging(MRI)of patients with spinal trauma.Methods Sixtytwo patients with spinal trauma were selected.All of them underwent CT and MRI examination,and the findings were observed.The detection results of CT and MRI were compared.Results The number of bone fragments detected by CT was significantly larger than that detected by MRI(P<0.05).The detection rates of MRI for spinal fracture and ligament injury were significantly higher than those of CT(P<0.05).CT detected 56 cases of spinal fractures,showing vertebral body deformation or vertebral wedge compression changes.There were 2 cases of cervical spondylolisthesis and 4 cases without obvious fracture signs.There were 27 cases of spinal canal volume changes mainly manifested as spinal stenosis and spinal canal occupied by bone fragments.Ligament injury showed significant thickening of the anterior or posterior longitudinal ligament,and the fracture cannot be clearly displayed.MRI detected 62 cases of spinal fractures,with posterior marginal bone fragments displacing to the spinal canal,T2WI high signal and T1WI low signal or equal signal in the vertebral body.MRI found 27 spinal canal volume changes,which was consistent with CT.The ligament injury showed ligament thickening,T2WI strip or patchy high signal and T1WI intermittent low signal.Meanwhile,the boundary between injured site with high signal and adjacent tissue was unclear.Paravertebral soft tissue injury showed T2WI patchy high signal and low T1WI signal.Conclusion CT can demonstrate the displacement of bone fragments in patients with spinal trauma clearly,while MRI has more advantages in detecting spinal fracture and ligament injury.These two imaging methods can be used reasonably according to the patient's condition.

关 键 词：脊柱创伤 计算机断层扫描 磁共振成像 影像学表现 

分 类 号：R445[医药卫生—影像医学与核医学] R814[医药卫生—诊断学]