急性脊髓损伤神经功能预后的预测：CT与MR的作用
Prediction of neurologic outcome in acute spinal cord injury: the role of CT and MR.
作者信息
Silberstein M, Tress B M, Hennessy O
机构信息
Department of Radiology, Austin Hospital, Heidelberg, Victoria, Australia.
出版信息
AJNR Am J Neuroradiol. 1992 Nov-Dec;13(6):1597-608.
PURPOSE
- To determine whether MR appearances of the spinal cord in acute trauma correlate with clinical prognosis, and 2) to identify other MR and CT prognostic factors in acute spinal trauma.
METHODS
Retrospective evaluation of MR, CT, and clinical examinations in 32 acute spinal trauma patients examined between 1987 and 1990.
RESULTS
All 21 patients with abnormal spinal cords on MR had complete motor paralysis at presentation, compared to only three of 11 patients with normal cords. Whereas cord transection and hemorrhagic contusion had poor prognoses, 73% of patients with cord edema and 100% of patients with normal cord had useful motor function at outcome. At follow-up MR, areas of cord contusion developed into cysts, while edema resolved, leaving residual areas of myelomalacia. Associated spinal fractures, ligament injury, and cord compression were associated (P < .05) with a worse prognosis. Spondylotic changes were a significant risk factor for spinal cord injury, mediated by cord compression.
CONCLUSIONS
MR and CT are valuable techniques for quantifying injury and predicting prognosis in acute spinal trauma.
目的
1）确定急性创伤中脊髓的磁共振成像（MR）表现是否与临床预后相关，以及2）识别急性脊柱创伤中的其他MR和CT预后因素。
方法
回顾性评估1987年至1990年间接受检查的32例急性脊柱创伤患者的MR、CT和临床检查结果。
结果
MR显示脊髓异常的所有21例患者在就诊时均出现完全性运动麻痹，而脊髓正常的11例患者中只有3例如此。脊髓横断和出血性挫伤预后较差，而73%的脊髓水肿患者和100%的脊髓正常患者在预后时具有有用的运动功能。在随访MR检查中，脊髓挫伤区域发展为囊肿，而水肿消退，留下脊髓软化的残留区域。相关的脊柱骨折、韧带损伤和脊髓受压与较差的预后相关（P <.05）。骨质增生改变是脊髓损伤的一个重要危险因素，由脊髓受压介导。
结论
MR和CT是量化急性脊柱创伤损伤和预测预后的有价值技术。
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