低场强MRI在急性脊髓炎检查和诊断中的应用.doc

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1、低场强MRI在急性脊髓炎检查和诊断中的应用作者：马德智，陆玉敏，李保生【摘要】　　目的探讨低场强MRI在急性脊髓炎检查与诊断中的应用价值，为影像诊断提供更多的依据。方法对临床确诊的12例急性脊髓炎的MRI和临床资料进行回顾分析。结果12例中病变累及颈髓者5例，颈髓至上段胸髓者1例，颈髓中、下段至上、中段胸髓者4例，下段胸髓受累2例；病变范围达4个以上椎体者10例；病变在T2WI上容易识别，均呈高或较高信号影，矢状位结合横轴位观察才能避免误判；5例脊髓轻度增粗，3例较明显增粗，4例脊髓形态改变不明显，脊髓形态改变在矢状位T1WI上显示清楚；3例行MRI对比增强检查，其中1例呈中度条状强化，2

2、例呈轻度斑片状强化，无占位效应。结论MRI能直观地反映急性脊髓炎的病理改变，是该病的一种理想影像检查和诊断技术。【关键词】磁共振成像脊髓炎/诊断　　Low-fieldandhigh-resolutionMRIinexaminationanddiagnosisofacutemyelitis　　MADe-zhi,LUYuminLIBao-sheng　　(DepartmentofRadiology,AffiliatedHospitalofYoujiangMedicalCollegeforNationalities,Baise,Guangxi533000,China)　　Abstract:Obje

3、ctiveToinvestigatetheclinicalvalueoflow-fieldandhigh-resolutionmagneticresonanceimaging(MRI)inexaminationanddiagnosisofacutemyelitis,soastoprovidemoreevidenceforimagediagnosis.MethodsTheMRIandclinicalmaterialsfrom12patientsprovenwithacutemyelitiswereprospectivelyanalysed.ResultsOf12patients,lesion

4、sin5casesextendedtocervicalspinalcord,ofwhich1casewithlesionslocatedfromcervicalspinalcordtoupperthoracicspinalcord,4caseslocatedfrommiddleandinferiorcervicalspinalcordtosuperiorandmiddlethoracicspinalcord,2casessufferedinferiorthoracicmyelitis.10patientssufferedmyelitiswithfourinjuredvertebralbod

5、ies.ThelesionswereeasilyidentifiedonT2WIimageswithhighorhigherresolution.Themisdiagnosiscouldbeavoidedviacross-sectionalincombinationwithsagittalscanningobservation.5caseswithslightcordenlargementwereobserved,and3withobviouscordenlargement.Thecordformationchangesin4caseswerenotobvious,andthcordfor

6、mationchangesinsagittalpositionwereclearonT1WIimages.3casesundergoing5contrast-intensityexamination,of1withmoderateintensifiedstreakand2withslightplaque,nospaceoccupyingresponsewasobserved.ConclusionMRIcancorrectlypresentthepathologicalchangesofacutemyelitis,whichresultsinareliabletechniqueforexam

7、inationanddiagnosisofacutemyelitis.　　Keywords:magneticresonanceimaging;myelitis/diagnosis　　急性脊髓炎是中枢神经系统较常见的疾病，临床上以急性横贯性脊髓损害为表现，过去主要依据病史、临床表现和脑脊液检查、并可辅以影像学的X线脊髓造影及CT进行诊断，但X线脊髓造影和CT对脊髓的显示存在很大的局限性已为人们所熟知。随着MRI在临床上的逐