论著-头颈部
脊柱外伤患者的CT及MRI影像表现及诊断价值比较
作者:吴陈欢1 郭 璇2 程中华1
所属单位:1.湖北省黄冈市中心医院脊柱关节 外科 (湖北 黄冈 438000) 2.武汉钢铁集团程潮铁矿医院内科 (湖北 鄂州 4360003)
PDF摘要
目的 观察脊柱外伤患者CT、MRI 影像表现并比较两者诊断价值。方法 对 本院2013年4月-2016年1月60例脊柱外伤 患者的CT、MRI资料进行回顾性分析,观 察患者CT、MRI图像表现,并比较两者对 脊椎骨折、碎骨片、韧带损伤等检出结 果。结果 CT显示脊椎骨折56例(93.3%), 表现为椎体变形或椎体楔状压缩;MRI显 示脊椎骨折60例(100.0%),椎体内呈现 T1WI低或等信号,T2WI高信号。MRI对脊 椎骨折检出率明显高于CT(P<0.05);CT 显示碎骨片176块,较MRI的121块差异有 统计学意义(P<0.05)。CT对脊椎曲度改 变、椎管容积改变、神经根损伤及椎旁软 组织损伤显示率与MRI比较差异无统计学 意义(P>0.05)。MRI对韧带损伤检出率为 68.3%显著高于CT的10.0%,差异有统计学 意义(P<0.05)。结论 CT在脊柱外伤碎骨 片显示上相比MRI更有优势,而MRI相比CT 在脊椎骨折、韧带损伤显示上更有优势, 各有优劣,临床根据患者情况灵活应用。
Objective To observe the CT and MRI findings of patients with spinal trauma and to compare the diagnostic value. Methods The CT and MRI data of 60 patients with spinal trauma who were admitted into our hospital between April 2013 and January 2016 were retrospectively analyzed. The CT and MRI findings were observed. The detection results of spinal fractures, bone pieces and ligament injury, etc. were compared between the two. Results CT showed that 56 cases (93.3%) were with spinal fractures, manifesting as vertebral deformation or vertebral wedge compression; MRI showed that 60 cases (100.0%) were with spinal fractures, showing low or equal signal on T1WI in vertebral body and high signal on T2WI. The detection rate of MRI in spinal fractures was significantly higher than CT (P<0.05). CT displayed 176 bone pieces. Compared with 121 pieces displayed by MRI, there was significant differences (P<0.05). There was no significant difference in display rates in change of spinal curvature, change of spinal canal volume, nerve root injury and paravertebral soft tissue injury between CT and MRI (P>0.05). The detection rate of MRI in ligament injury (68.3%0 was significantly higher than that of CT (10.0%) (P<0.05). Conclusion CT has more advantages in displaying bone pieces of spinal trauma over MRI, while MRI has more advantages in displaying spinal fracture and ligament injury over CT. They have their own advantages and disadvantages. They can be chosen according to patient's condition.
【关键词】脊柱外伤;CT;MRI;影像表现;脊髓损伤
【中图分类号】R683.2;R445.3;R445.2
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.07.039
前言
脊柱解剖结构较为复杂,当其损伤后可能引发脊髓损伤、韧带损 伤等,若发现不及时或治疗不当可能致残或死亡[1]。为此早期通过影 像学技术准确判断脊柱损伤、曲度改变等脊柱外伤情况对其治疗方案 制定、预后评估具有十分重要的意义。过去临床诊断脊柱外伤以X线为 主,但常规X线对骨折现象难以发现,仅在患者出现粉碎骨折时方可 清楚显示骨折线,延误病情[2]。近年来CT、MRI在脊柱外伤诊断中应用 越来越多,对脊柱外伤相关情况可全面了解,为临床诊治提供重要依 据。为了选择一种更有效诊断方法,本研究对本院2013年4月~2016年 1月就诊的60例脊柱外伤患者的CT、MRI影像学资料进行比较,报告如下。
中国CT和MRI杂志
第14卷, 第 7 期
2016年07月
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