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[儿童脊柱损伤后MRI检测到的“骨挫伤”的临床相关性]

[Clinical relevance of "bone bruise" detected by MRI following spinal injuries in children].

作者信息

Scheunemann D, Lehmann W, Briem D, Stork A, Windolf J, Rueger J M, Linhart W

机构信息

Zentrum für Operative Medizin, Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum, Hamburg-Eppendorf.

出版信息

Unfallchirurg. 2005 Aug;108(8):638-44. doi: 10.1007/s00113-005-0934-z.

Abstract

BACKGROUND

MRI is a sensitive diagnostic tool, which is especially suited for the diagnosis of vertebral injuries in children since no radiation has to be applied to gonads or blood-producing organs. An indirect sign of vertebral injury is the presence of "bone bruise," an edema of the vertebral body without other bony lesions. The purpose of this study was to elucidate the clinical significance of "bone bruise" following vertebral trauma in children.

PATIENTS AND METHODS

Between 1998 and 2003 a total of 66 children with vertebral injuries were treated at our institution; 34 of these patients initially underwent MRI. In this retrospective study 20 of these children who were diagnosed with a vertebral injury based on the presence of a "bone bruise" in an MRI on admission were examined clinically as well as by follow-up MRI.

RESULTS

All 20 patients stated they felt no limitations in daily activities. On examination there were no significant pathologic findings. We did not note persistence of a "bone bruise" or a collapse of the affected bone in the follow-up MRI.

CONCLUSION

If a "bone bruise" is detected in the MRI after vertebral trauma in children, it usually has a good prognosis. With adequate therapy, which in our regimen consists of bedrest and early mobilization, we did not note any secondary collapse of the affected vertebrae.

摘要

背景

磁共振成像(MRI)是一种敏感的诊断工具,特别适用于儿童椎体损伤的诊断,因为无需对性腺或造血器官进行辐射。椎体损伤的一个间接征象是“骨挫伤”的存在,即椎体水肿而无其他骨质病变。本研究的目的是阐明儿童椎体创伤后“骨挫伤”的临床意义。

患者与方法

1998年至2003年间,我院共治疗了66例椎体损伤儿童;其中34例患者最初接受了MRI检查。在这项回顾性研究中,对20例入院时MRI显示存在“骨挫伤”而被诊断为椎体损伤的儿童进行了临床检查和随访MRI检查。

结果

所有20例患者均表示日常活动无受限。检查时未发现明显病理表现。在随访MRI中,我们未发现“骨挫伤”持续存在或受累骨骼塌陷。

结论

如果在儿童椎体创伤后的MRI中检测到“骨挫伤”,其预后通常良好。通过适当的治疗,在我们的治疗方案中包括卧床休息和早期活动,我们未发现受累椎体有任何继发性塌陷。

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