›› 2014, Vol. 35 ›› Issue (6): 650-650.

• 论文 • 上一篇    下一篇

急性颈椎创伤磁敏感加权成像及STIR扫描序列的应用价值

曹磊;刘记存;吝娜;李晓娜;彭志刚;吴文娟   

  1. 河北医科大学第三医院放射科,河北省骨科生物力学重点实验室,河北 石家庄050051
  • 发布日期:2014-06-25

ZHAO Zhiming;CUI Na;HAO Guimin;XU Suxin

CAO Lei;LIU Jicun;LIN Na;LI Xiaona;PENG Zhigang;WU Wenjuan   

  • Published:2014-06-25

摘要: 目的:比较常规磁共振成像( magnetic resonance imaging,MRI)序列、短时间反转恢复序列( short-tau inversion recovery,STIR)、多回波采集的T2 WI梯度回波序列( multiple-echo image combination gradient-echo sequence, ME2D)、磁敏感加权成像( susceptibility weighted imaging,SWI)序列在急性颈椎创伤中的应用价值。方法30例急性颈椎创伤患者,均应用德国西门子3.0T扫描机对其进行常规MRI(T1WI和T2WI)、STIR、ME2D及高分辨率SWI检查。比较T2 WI与STIR对椎体、椎间盘及椎旁韧带损伤的检出情况。对脊髓出血的患者,选择ME2D和SWI的同一层面(显示出血最清楚层面),分别测量脊髓出血与周围正常脊髓组织信号强度并计算其信号强度比。结果STIR检测急性创伤椎体异常信号、棘间韧带、项韧带损伤检出率高于T2 WI(χ2=21.043、1063.499、859.982,P<0.01)。两者对棘间韧带、项韧带损伤检出结果一致性较差( Kappa=0.336、0.329,);T2 WI和STIR序列在检出椎间盘损伤及前、后纵韧带损伤程度方面的差异无统计学意义。SWI显示脊髓出血部位与周围正常脊髓组织的信号强度比低于ME2D,差异有统计性意义( Z=2.52,P=0.014)。结论在颈椎创伤的MRI平扫中,STIR较T2 WI对椎体及后方韧带损伤的显示具有明显的优势,STIR应作为脊柱损伤的常规扫描序列;而SWI在显示及证实脊髓出血方面较常规T2 WI、ME2D更敏感,应作为脊髓损伤的重要补充序列。

关键词: 颈椎, 创伤和损伤, 磁共振成像

Abstract: Objective To compare conventional MRI,short-tau inversion recovery( STIR ), multiple-echo image combination gradient-echo sequence( ME2D)and susceptibility weighted imaging (SWI)in acute cervical spine trauma. Methods Conventional T1WI,T2WI,STIR,ME2D and high-resolution SWI were performed in 30 patients with a history of acute cervical spine injury using a 3 Tesla MRI system( Verio,siemens,Germany ). The detection of vertebral body,intervertebral disc and paravertebral ligament injury by T2 WI and STIR were analyzed. The signal intensity in the hemorrhage and normal spinal cord were measured on the same slice of ME2D and SWI,respectively,and the signal intensity ratio of the hemorrhage to normal spinal cord were calculated. Results Compared with T2 WI, STIR sequence had higher detection rate in showing vertebral bodies injuries,interspinal ligament and nuchal ligament injuries(χ2 =21 . 043 ,1 063 . 499 ,859 . 982 ,P<0 . 01 ),the consistency of result of STIR and T2 WI in detecting injury of interspinal ligament and nuchal ligament was poor( Kappa= 0. 336 and 0 . 329 ). There was no significant difference between STIR and T2 WI in detecting injury of intervertebral disc,anterior longitudinal ligament and posterior longitudinal ligament. Compared with ME2D,SWI sequence could show lower signal intensity ratio of the hemorrhage to normal spinal cord,and there were statistical differences(Z=2. 52,P=0. 014). Conclusion Compared with T2WI,STIR has significant advantage in detecting injury of vertebral body and posterior ligament complex,so STIR should be included in the routine MRI sequence of acute cervical spine trauma;SWI is more sensitive than T2 WI and ME2 D in showing and confirming hemorrhage in acute cervical cord injury and should serve as important complement sequence for acute spinal cord injury.

Key words: cervical vertebrae, wounds and injuries, magnetic resonance imaging

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