Buchberger W, Springer P, Birbamer G, Judmaier W, Kathrein A, Daniaux H
Universitätsklinik für Radiodiagnostik, Universität Innsbruck.
Rofo. 1995 Jul;163(1):53-9. doi: 10.1055/s-2007-1015943.
To assess the value of MR imaging in the acute and chronic stages of spinal trauma.
126 MR examinations of 120 patients were evaluated retrospectively. In 15 cases of acute spinal cord injury, correlation of MR findings with the degree of neurological deficit and eventual recovery was undertaken.
Cord anomalies in the acute stage were seen in 16 patients. Intramedullary haemorrhage (n = 6) and cord transection (n = 2) were associated with complete injuries and poor prognosis, whereas patients with cord oedema (n = 7) had incomplete injuries and recovered significant neurological function. In the chronic stage, MR findings included persistent cord compression in 8 patients, syringomyelia or post-traumatic cyst in 12, myelomalacia in 6, cord atrophy in 9, and cord transection in 7 patients.
In acute spinal trauma, MR proved useful in assessing spinal cord compression and instability. In addition, direct visualisation and characterisation of post-traumatic changes within the spinal cord may offer new possibilities in establishing the prognosis for neurological recovery. In the later stages, potentially remediable causes of persistent or progressive symptoms, such as chronic spinal cord compression or syringomyelia can be distinguished from other sequelae of spinal trauma, such as myelomalacia, cord transection or atrophy.
评估磁共振成像(MR)在脊柱创伤急性和慢性阶段的价值。
回顾性评估120例患者的126次MR检查。对15例急性脊髓损伤患者,分析MR表现与神经功能缺损程度及最终恢复情况的相关性。
16例患者在急性期出现脊髓异常。髓内出血(6例)和脊髓横断(2例)与完全性损伤及预后不良相关,而脊髓水肿患者(7例)为不完全性损伤,神经功能有显著恢复。在慢性期,MR表现包括8例患者存在持续性脊髓压迫,12例有脊髓空洞症或创伤后囊肿,6例有脊髓软化,9例有脊髓萎缩,7例有脊髓横断。
在急性脊柱创伤中,MR有助于评估脊髓压迫和脊柱稳定性。此外,直接观察和确定脊髓创伤后的变化可能为判断神经恢复预后提供新的依据。在后期,可区分导致持续或进行性症状的潜在可治疗原因,如慢性脊髓压迫或脊髓空洞症,与脊柱创伤的其他后遗症,如脊髓软化、脊髓横断或萎缩。