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非创伤性脊髓病的临床-放射学方法。

Clinical-radiological approach to nontraumatic myelopathy.

机构信息

Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, España.

Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, España.

出版信息

Radiologia (Engl Ed). 2020 Nov-Dec;62(6):464-480. doi: 10.1016/j.rx.2020.07.004. Epub 2020 Oct 14.

Abstract

Diseases of the spinal cord often have devastating consequences and imaging studies are indispensable for their diagnosis. The fundamental imaging technique to evaluate these diseases is magnetic resonance imaging of the spine. The diagnostic approach must be based on the clinical context, the time elapsed since the onset of symptoms and signs, and the imaging findings; for this reason, it sometimes necessary to broaden the study to include the brain. The first step in the diagnostic algorithm is to rule out spinal cord compression before evaluating other causes of myelopathy, which sometimes has multiple causes. This paper includes a broad review of the different diseases that can cause myelopathy, their imaging manifestations, their differential diagnoses, and diagnostic algorithms. Using an appropriate radiological approach will result in better management and prognosis of these patients.

摘要

脊髓疾病常带来严重后果,影像学检查对其诊断不可或缺。评估这些疾病的基本影像学方法是脊柱磁共振成像。诊断方法必须基于临床背景、症状和体征出现的时间以及影像学发现;因此,有时有必要扩大研究范围,包括大脑。诊断算法的第一步是排除脊髓压迫,然后再评估脊髓病变的其他原因,后者有时有多种病因。本文广泛综述了可引起脊髓病变的不同疾病、其影像学表现、鉴别诊断和诊断算法。采用适当的影像学方法可改善这些患者的治疗和预后。

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