Prestar F J, Moldenhauer H
Neurochirurgische Abteilung, Knappschaftis-Krankenhaus Bergmannsheil, Gelsenkirchen-Buer.
Aktuelle Traumatol. 1993 Aug;23(5):223-9.
MRI has been evaluated in a series of 26 patients, who suffered blunt cervical spine injuries at least 6 weeks previously, and had continuous clinical signs of radicular (n = 8) and medullary (n = 18) syndromes. In 6 patients MRI visualised localised posttraumatic intramedullary parenchymal changes; 5 patients had posttraumatic cord atrophies and 2 patients "traumatic" disc herniations. Besides direct traumatic lesions, pre-existing uni-, bi- or multisegmental degenerative cervical spinal stenosis must be considered because it predisposes to spinal cord injury. MRI is an important supplementary diagnostic measure after cervical spine trauma when there are clinical signs of cervical local, radicular or medullary syndromes, because intra- or extramedullary lesions can be visualised. However it must be emphasized that with present MR techniques not all "microcystic" posttraumatic spinal cord degenerations can be visualised, even if there are clear neurological signs of myelopathy or radiculopathy.
对26例患者进行了磁共振成像(MRI)评估,这些患者至少在6周前遭受过颈椎钝性损伤,并有持续的神经根性(n = 8)和脊髓性(n = 18)综合征的临床体征。6例患者的MRI显示有局部创伤后髓内实质改变;5例患者有创伤后脊髓萎缩,2例患者有“创伤性”椎间盘突出。除了直接创伤性病变外,还必须考虑先前存在的单节段、双节段或多节段退行性颈椎管狭窄,因为它易导致脊髓损伤。当有颈椎局部、神经根性或脊髓性综合征的临床体征时,MRI是颈椎创伤后一项重要的辅助诊断措施,因为可以显示髓内或髓外病变。然而必须强调的是,即使存在明确的脊髓病或神经根病神经体征,采用目前的磁共振技术也并非所有“微囊性”创伤后脊髓退变都能显示出来。