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[磁共振成像诊断胸腰椎骨折后韧带复合体损伤的可靠性]

[Reliability of magnetic resonance imaging in diagnosing posterior ligament complex injury in thoracolumbar fractures].

作者信息

Zhang Tao, Feng Shi-Qing, Jiang Wen-Xue

机构信息

Department of Orthopaedics, Tianjin First Central Hospital, Tianjin 300192, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Aug 15;46(16):1241-4.

Abstract

OBJECTIVE

To analyze the reliability of magnetic resonance imaging (MRI) in detecting posterior ligament complex injury in thoracolumbar fractures.

METHODS

Ninety-five patients with thoracolumbar fracture were evaluated by palpation of the inter-spinal gap, plain radiography, and MRI before operation. In addition to conventional MRI sequences, a fat-suppressed T2-weighted sagittal sequence was performed. Surgery was performed by a posterior approach. During the operation, posterior ligament complex was examined.

RESULTS

A wide inter-spinal gap was palpated in 41 patients and was found in 55 patients on plain radiography. According to MRI, injury to the supraspinal ligament was suspected in 85 patients, the inter-spinal ligament in 83 patients, and the ligamentum flavum in 26 patients. There were 82 supraspinal ligament injuries, 80 inter-spinal ligament injuries, and 20 ligamentum flavum injuries in operative findings. The relations between plain radiography and operative findings, between MRI interpretation and operative findings were statistically significant.

CONCLUSION

A fat-suppressed T2-weighted sagittal sequence of MRI is a highly sensitive, specific, and accurate method to detect posterior ligament complex injury and which is recommended for the accurate evaluation of posterior ligament complex injury in thoracolumbar fractures.

摘要

目的

分析磁共振成像(MRI)检测胸腰椎骨折后韧带复合体损伤的可靠性。

方法

对95例胸腰椎骨折患者在术前通过触诊棘间隙、X线平片及MRI进行评估。除常规MRI序列外,还进行了脂肪抑制T2加权矢状位序列检查。采用后路手术。术中对后韧带复合体进行检查。

结果

41例患者触诊发现棘间隙增宽,X线平片检查发现55例患者棘间隙增宽。根据MRI检查,85例患者怀疑棘上韧带损伤,83例患者怀疑棘间韧带损伤,26例患者怀疑黄韧带损伤。手术发现棘上韧带损伤82例,棘间韧带损伤80例,黄韧带损伤20例。X线平片检查结果与手术发现之间、MRI诊断结果与手术发现之间的关系具有统计学意义。

结论

MRI脂肪抑制T2加权矢状位序列是检测后韧带复合体损伤的一种高度敏感、特异且准确的方法,推荐用于准确评估胸腰椎骨折后韧带复合体损伤。

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