儿童脊柱损伤：磁共振成像的作用
Spinal injuries in children: role of MR.
作者信息
Davis P C, Reisner A, Hudgins P A, Davis W E, O'Brien M S
机构信息
Department of Radiology (Neuroradiology), Egleston Children's Hospital, Emory University, Atlanta, GA 30322.
出版信息
AJNR Am J Neuroradiol. 1993 May-Jun;14(3):607-17.
PURPOSE
To define the clinical and prognostic role of MR in a pediatric population with spinal cord injury.
METHODS
Fifteen children underwent MR 12 hours to 2 months postinjury using decoupled surface coils and ventilator support as needed. MR was correlated retrospectively with clinical, CT, and radiographic findings.
RESULTS
On MR, of seven children with spinal cord neurologic deficits, four had hemorrhagic contusions, one had nonhemorrhagic contusion, one had extensive infarction, and one revealed a normal cord. All had persistent deficits on hospital discharge. Eight without cord neurologic deficit revealed no cord lesions on MR; this group included two with epidural hematoma, four with ligamentous disruption, and two with bone compression.
CONCLUSIONS
Children may have extensive cord contusion and/or infarction with minor, remote, or no fracture dislocation. Because both hemorrhagic and nonhemorrhagic cord lesions found on MR were associated with significant, persistent cord deficits, the authors conclude that MR provides a practical tool for diagnosis/prognosis in children with acute/subacute spinal injury.
目的
明确磁共振成像（MR）在小儿脊髓损伤患者中的临床及预后作用。
方法
15例儿童在受伤后12小时至2个月接受了MR检查，使用去耦表面线圈，并根据需要给予呼吸机支持。MR结果与临床、CT及影像学检查结果进行回顾性对比。
结果
在接受MR检查的7例有脊髓神经功能缺损的儿童中，4例有出血性挫伤，1例有非出血性挫伤，1例有广泛梗死，1例脊髓正常。所有患儿出院时均有持续性神经功能缺损。8例无脊髓神经功能缺损的患儿MR检查未发现脊髓损伤；该组包括2例硬膜外血肿、4例韧带断裂和2例骨质压迫。
结论
儿童可能存在广泛的脊髓挫伤和/或梗死，而骨折脱位轻微、部位较远或无骨折脱位。由于MR检查发现的出血性和非出血性脊髓损伤均与严重、持续性脊髓神经功能缺损相关，作者得出结论，MR为急性/亚急性脊髓损伤患儿的诊断/预后评估提供了一种实用工具。
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