Schröder R J, Vogl T, Hidajat N, Schedel H, Südkamp N, Haas N, Felix R
Strahlenklinik und Poliklinik Universitätsklinikum Rudolf Virchow Freie Universität Berlin.
Aktuelle Radiol. 1995 Jul;5(4):197-202.
The aim of our study was to compare the diagnostic capacities of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnostic evaluation of acute cervical spinal column injuries. We examined 39 patients with cervical spine injury suspected either clinically or by plain radiography, or even confirmed. In 30 patients, 86 acute traumatic lesions were observed in the area of the cervical spine, 83% of which were retrospectively recognisable by CT and 95% on MRI films. In nine patients, no acute traumatic pathologic pattern could be found either by CT or by MRI or any other subsequently employed diagnostic methods. CT yielded 100% of the osseous acute traumatic findings, the degenerative lesions narrowing the spinal channel, and of the dislocations, but only 33% of the lesions of the longitudinal ligaments, 50% of intramedullary haemorrhages, 60% of paravertebral soft tissue haematomas, 83% of vertebral disc herniations of protrusions, and none of the six nonhaemorrhagic spinal cord contusions. Without exception, MRI revealed all the traumatic medullary and paravertebral soft tissue changes, dislocations, and spondylophytes narrowing the spinal channel, but only 50% of the C2-odonteous fractures, 89% of the transverse processes', and 92% of the vertebral lamina fractures. Basing on these results, after primary plain film radiograph imaging, the performance of MRI seems to be recommendable prior to CT in diagnostic evaluation of traumatic cervical spinal lesions, if possible with regard to the patient's clinical state and the global organization, unless immediate CT imaging of other body regions (i.e. of the head) is already being planned anyway, Nevertheless, MRI should not be abandoned within the overally framework of this disease pattern.
我们研究的目的是比较计算机断层扫描（CT）和磁共振成像（MRI）在急性颈椎损伤诊断评估中的诊断能力。我们检查了39例临床上怀疑或经X线平片检查甚至已确诊的颈椎损伤患者。在30例患者中，在颈椎区域观察到86处急性创伤性病变，其中83%可通过CT回顾性识别，95%可在MRI片上识别。在9例患者中，CT、MRI或任何其他随后采用的诊断方法均未发现急性创伤性病理模式。CT能发现100%的急性骨创伤性表现、使椎管狭窄的退行性病变和脱位，但只能发现33%的纵韧带损伤、50%的脊髓内出血、60%的椎旁软组织血肿、83%的椎间盘突出或膨出，以及6例非出血性脊髓挫伤均未发现。无一例外，MRI显示了所有创伤性脊髓和椎旁软组织变化、脱位以及使椎管狭窄的骨赘，但只能发现50%的C2齿突骨折、89%的横突骨折和92%的椎板骨折。基于这些结果，在进行初步X线平片成像后，如果根据患者的临床状况和整体安排可行，在创伤性颈椎病变的诊断评估中，MRI的表现似乎比CT更值得推荐，除非已经计划对身体其他部位（即头部）进行立即CT成像。然而，在这种疾病模式的总体框架内，MRI不应被放弃。
