Uské A, Héritier F, Schaller M D
Centre hospitalier universitaire vaudois, Lausanne.
Schweiz Z Sportmed. 1993 Jun;41(2):63-6.
In case of a type II decompression sickness (with cerebrospinal injury), the decision on how to structure a prompt hyperbaric treatment rests on an anamnesis and the clinical investigation. In looking for an associated contingent barotrauma, one has to be satisfied with an X-ray of thorax and abdomen. The myelopathy which results from a decompression mishap with medullary involvement forms a very peculiar clinical entity defined by a fascicular injury at several levels. For several years now, clinical radiologists resort to a new medical imaging technique: Nuclear Magnetic Resonance (NMR-)Imaging. For the first time, this technique allows the imaging of intramedullary lesions due to a decompression accident. Other neuroradiological investigations (such as myelography, spinal tomodensitometry, medullary angiography, isotopic tests) are without merit for evaluating decompression accidents with medullary involvement. NMR-Imaging has the potential too, of revealing ischemic cerebral injuries, even if the clinical brain impairment is often silent and therefore overlooked. The role of NMR-Imaging for evaluating cerebrospinal aspect of decompression accidents is not yet finalized. However, NMR-Imaging will give without any doubt a boost to the pathophysiological knowledge of decompression mishaps.
对于II型减压病（伴有脑脊髓损伤），关于如何安排及时的高压氧治疗的决策取决于病史和临床检查。在寻找相关的并发气压伤时，只能满足于进行胸部和腹部X线检查。由减压事故导致的伴有脊髓受累的脊髓病形成了一种非常特殊的临床实体，其特征是多个层面的束状损伤。几年来，临床放射科医生采用了一种新的医学成像技术：核磁共振（NMR）成像。这项技术首次能够对减压事故导致的髓内病变进行成像。其他神经放射学检查（如脊髓造影、脊髓体层摄影、脊髓血管造影、同位素检查）对于评估伴有脊髓受累的减压事故并无价值。NMR成像还有可能揭示缺血性脑损伤，即使临床上脑部损伤往往没有症状，因此容易被忽视。NMR成像在评估减压事故的脑脊髓方面的作用尚未确定。然而，NMR成像无疑将推动对减压事故病理生理学知识的了解。
