急性颈部外伤的MR扩散张量成像

发布时间：2018-03-19 14:30

本文选题：颈部外伤　切入点：扩散张量成像　出处：《临床放射学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨扩散张量成像(DTI)及纤维示踪技术(FT)在评价急性颈部外伤时脊髓损伤中的价值。方法搜集急性期颈部外伤患者28例。脊髓损伤程度根据临床分为轻度、中度和重度。同时根据常规T2WI颈髓是否为高信号将外伤患者分为高信号组(A组)和正常信号组(B组)。采用SPSS 16.0统计软件进行统计学分析,以P0.05为差异有统计学意义。结果 A、B组及健康对照组颈髓表观扩散系数(ADC)值及各向异性分数(FA)值差异均有统计学意义(P0.05)。轻度、中度和重度颈髓损伤组的ADC值及FA值差异同样有统计学意义(P0.05)。三组与健康对照组的两侧内囊后肢的ADC值差异无统计学意义(P0.05),重度颈髓损伤组与健康对照组的内囊后肢FA值差异有统计学意义(P0.05)。轻度颈髓损伤组DTT纤维束结构走行未见明显改变;中度及重度颈髓损伤组DTT显示纤维束各有变化。A组受伤节段的颈髓DTI纤维束图像显示稀疏、移位和部分扭曲断裂,B组受伤节段的颈髓DTI纤维束图像仅见部分稀疏改变,无明显移位和扭曲断裂发生,健康对照组显示纤维束饱满,结构清晰,走行自然。结论 DTI技术能早期发现隐匿性颈髓损伤,同时ADC值和FA值还能定量客观反映颈髓损伤具体程度;FT可直接观察纤维束是否稀疏、移位及扭曲断裂等征象;急性重度颈髓损伤者会同时伴有走行于内囊后肢的皮质脊髓束的微观病理改变。
[Abstract]:Objective to investigate the diffusion tensor imaging (DTI) and fiber tractography (FT) in value in evaluation of acute spinal cord injury of neck trauma. Methods 28 cases of patients with acute neck trauma. According to the clinical severity of spinal cord injury were divided into mild, moderate and severe. At the same time according to the conventional T2WI for cervical spinal cord injury patients were divided into high signal high signal group (A group) and normal signal group (group B). Statistical analysis was performed using SPSS 16 statistical software, using P0.05 as the difference was statistically significant. The results of A, B and control group with cervical cord apparent diffusion coefficient (ADC) value and the fractional anisotropy (FA) values of statistical significance (P0.05). The differences were mild, moderate and severe cervical spinal cord injury group, the ADC and FA values of the same difference was statistically significant (P0.05). The three group and the healthy control group on both sides of the posterior limb of the internal capsule was no significant difference between ADC values (P0.05), severe cervical spinal cord injury group and health The control group of the posterior limb of the internal capsule FA values had significant difference (P0.05). Mild cervical spinal cord injury group DTT fiber bundle structure for no obvious change; moderate and severe cervical spinal cord injury group DTT showed that the fiber bundle of cervical spinal cord DTI fibers have changes in.A group injury section beam image sparse, shift and distortion of parts fracture, B segment of cervical spinal cord injury group DTI fibers were sparse image change, no obvious displacement and distortion of the fracture occurred, the healthy control group showed fiber bundle full, clear structure, walking naturally. Conclusion DTI can detect early occult cervical spinal cord injury, while ADC and FA values can reflect the quantitative the degree of cervical spinal cord injury; FT can directly observe the fiber bundle is sparse, shift and torsion fracture signs; change of the corticospinal tract micro pathology of acute severe cervical spinal cord injury may be accompanied by walking in the posterior limb of the internal capsule.

【作者单位】：南京医科大学附属儿童医院超声科;安徽医科大学第一附属医院放射科;
【分类号】：R445.2;R651.2

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