儿童无骨折脱位型脊髓损伤的MRI特征
发布时间：2019-06-11 18:34
【摘要】：目的:回顾性分析儿童无骨折脱位型脊髓损伤(SCIWORA)的MR影像学表现及临床特点,提高对儿童SCIWORA MRI特征的认识。方法:对2004年4月-2011年10月我院诊断为SCIWORA的10例患儿的临床及脊柱MRI资料进行回顾性分析。结果:10例患儿均于外伤后(车祸碾压腰腹部1例,外力打击腰部2例,舞蹈练习下腰7例),立即至3天后出现下肢无力、疼痛等脊髓损伤症状,10min~3d(中位时间3.5h)后症状达高峰,出现下肢瘫痪,症状稳定不再进展。伤后2~10d行首次脊柱MRI检查,病变累及全脊髓的1例,累及下颈段、胸段、腰段1例,累及胸段者2例,累及胸、腰段的6例。MRI显示脊髓水肿4例,呈长T2长T1信号;脊髓水肿伴出血6例,出血呈短T1信号。11~18d复查者10例,病变范围减小1例,范围增大2例,范围无变化7例。复查时出血者3例。伤后32~42d复查者4例,均发现脊髓萎缩。本组合并非神经性软组织损伤1例,可见前纵韧带损伤。结论:全脊柱MRI检查是用于诊断儿童SCIWORA的最佳影像学检查方法,不仅可进行脊髓损伤的神经影像学评估,还可显示脊柱X线及CT无法直接显示的脊柱韧带、椎间盘、终板及骨髓等非神经性软组织损伤情况,有利于临床治疗方案的制定及预后评估。
[Abstract]:Objective: to analyze the MR imaging features and clinical features of (SCIWORA) in children without fracture and dislocation spinal cord injury, and to improve the understanding of SCIWORA MRI features in children. Methods: the clinical and spinal MRI data of 10 children with SCIWORA diagnosed in our hospital from April 2004 to October 2011 were analyzed retrospectively. Results: the symptoms of spinal cord injury such as weakness of lower extremity and pain occurred immediately to 3 days after trauma (1 case of car accident crushed waist and abdomen, 2 cases of external force hit waist and 7 cases of lower waist of dance practice). After 10min~3d (median time 3.5 h), the symptoms reached the peak, paralysis of lower extremity and stable symptoms did not progress. The first spinal MRI examination was performed on the 2nd and 10th day after injury. 1 case involved the whole spinal cord, 1 case involved the lower cervical segment, chest segment, lumbar segment, 2 cases involved the chest segment, 6 cases involved the chest and lumbar segment. MRI showed spinal cord edema in 4 cases, long T2 long T1 signal intensity in 6 cases, spinal cord edema with hemorrhage in 6 cases, bleeding in 10 cases, the lesion scope decreased in 1 case, the range increased in 2 cases, and the range remained unchanged in 7 cases. There were 3 cases of bleeding at the time of reexamination. Spinal cord atrophy was found in 4 cases (32 / 42 days after injury). This combination is not nerve soft tissue injury in 1 case, anterior longitudinal ligament injury can be seen. Conclusion: total spinal MRI is the best imaging method for the diagnosis of SCIWORA in children. It can not only evaluate the neuroimaging of spinal cord injury, but also show the non-nerve soft tissue injury such as spinal ligament, intervertebral disc, endplate and bone marrow, which can not be directly displayed by spinal X-ray and CT, which is beneficial to the formulation of clinical treatment plan and prognosis evaluation.
【作者单位】： 首都医科大学附属北京儿童医院影像中心;首都医科大学附属北京儿童医院神经内科;
【分类号】：R726.5;R445.2
[Abstract]:Objective: to analyze the MR imaging features and clinical features of (SCIWORA) in children without fracture and dislocation spinal cord injury, and to improve the understanding of SCIWORA MRI features in children. Methods: the clinical and spinal MRI data of 10 children with SCIWORA diagnosed in our hospital from April 2004 to October 2011 were analyzed retrospectively. Results: the symptoms of spinal cord injury such as weakness of lower extremity and pain occurred immediately to 3 days after trauma (1 case of car accident crushed waist and abdomen, 2 cases of external force hit waist and 7 cases of lower waist of dance practice). After 10min~3d (median time 3.5 h), the symptoms reached the peak, paralysis of lower extremity and stable symptoms did not progress. The first spinal MRI examination was performed on the 2nd and 10th day after injury. 1 case involved the whole spinal cord, 1 case involved the lower cervical segment, chest segment, lumbar segment, 2 cases involved the chest segment, 6 cases involved the chest and lumbar segment. MRI showed spinal cord edema in 4 cases, long T2 long T1 signal intensity in 6 cases, spinal cord edema with hemorrhage in 6 cases, bleeding in 10 cases, the lesion scope decreased in 1 case, the range increased in 2 cases, and the range remained unchanged in 7 cases. There were 3 cases of bleeding at the time of reexamination. Spinal cord atrophy was found in 4 cases (32 / 42 days after injury). This combination is not nerve soft tissue injury in 1 case, anterior longitudinal ligament injury can be seen. Conclusion: total spinal MRI is the best imaging method for the diagnosis of SCIWORA in children. It can not only evaluate the neuroimaging of spinal cord injury, but also show the non-nerve soft tissue injury such as spinal ligament, intervertebral disc, endplate and bone marrow, which can not be directly displayed by spinal X-ray and CT, which is beneficial to the formulation of clinical treatment plan and prognosis evaluation.
【作者单位】： 首都医科大学附属北京儿童医院影像中心;首都医科大学附属北京儿童医院神经内科;
【分类号】：R726.5;R445.2
【参考文献】
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