【摘要】：目的:回顧性分析兒童無骨折脫位型脊髓損傷(SCIWORA)的MR影像學(xué)表現(xiàn)及臨床特點,提高對兒童SCIWORA MRI特征的認(rèn)識。方法:對2004年4月-2011年10月我院診斷為SCIWORA的10例患兒的臨床及脊柱MRI資料進(jìn)行回顧性分析。結(jié)果:10例患兒均于外傷后(車禍碾壓腰腹部1例,外力打擊腰部2例,舞蹈練習(xí)下腰7例),立即至3天后出現(xiàn)下肢無力、疼痛等脊髓損傷癥狀,10min~3d(中位時間3.5h)后癥狀達(dá)高峰,出現(xiàn)下肢癱瘓,癥狀穩(wěn)定不再進(jìn)展。傷后2~10d行首次脊柱MRI檢查,病變累及全脊髓的1例,累及下頸段、胸段、腰段1例,累及胸段者2例,累及胸、腰段的6例。MRI顯示脊髓水腫4例,呈長T2長T1信號;脊髓水腫伴出血6例,出血呈短T1信號。11~18d復(fù)查者10例,病變范圍減小1例,范圍增大2例,范圍無變化7例。復(fù)查時出血者3例。傷后32~42d復(fù)查者4例,均發(fā)現(xiàn)脊髓萎縮。本組合并非神經(jīng)性軟組織損傷1例,可見前縱韌帶損傷。結(jié)論:全脊柱MRI檢查是用于診斷兒童SCIWORA的最佳影像學(xué)檢查方法,不僅可進(jìn)行脊髓損傷的神經(jīng)影像學(xué)評估,還可顯示脊柱X線及CT無法直接顯示的脊柱韌帶、椎間盤、終板及骨髓等非神經(jīng)性軟組織損傷情況,有利于臨床治療方案的制定及預(yù)后評估。
[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.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院影像中心;首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R726.5;R445.2

【參考文獻(xiàn)】

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