Susceptibility weighted imaging in detecting hemorrhage in acute cervical spinal cord injury
Susceptibility weighted imaging in detecting hemorrhage in acute cervical spinal cord injury
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DOI：
10.1016/j.mri.2010.10.016
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发表时间：
2011-04-01
影响因子：
2.5
通讯作者：
Shi, Dapeng
中科院分区：
文献类型：
--
作者：
Wang, Meiyun;Dai, Yongming;Shi, Dapeng
背景和目的：磁化率加权成像(SWI)对脱氧血红蛋白和含铁血黄素等血液产物检测脑内微量出血敏感。然而，目前尚无SWI在脊髓损伤中的应用研究。本研究的目的是评价SWI在检测急性颈髓损伤(SCI)出血中的作用。材料和方法：对23例有急性颈椎创伤病史的患者进行研究。所有患者均于伤后15天内行高分辨率SWI、梯度回波(GRE)T2*加权像(T2*WI)和常规磁共振成像(MRI)。根据MRI表现，将患者分为正常脊髓、脊髓水肿、脊髓挫伤和脊髓出血四种类型。在T2*WI和SWI的同一层面上计算并比较出血与正常脊髓的信号比，进行定量分析。所有患者均在随访中进行临床评估。结果：在23例有急性颈椎损伤病史的患者中，4例常规MRI和SWI均显示脊髓正常，8例仅有脊髓水肿，5例有挫伤，而5例脊髓挫伤患者常规MRI有2例出血，6例常规MRI有椎管内出血，6例SWI均有出血。T2*WI和SWI上出血与正常组织的信号比差异有统计学意义(Z=2.34，P=0.02)。结论：磁化率加权成像对急性颈髓损伤出血的诊断较常规MRI更敏感。这项技术可以被证明是一种有用的工具，在颈椎脊髓损伤患者的常规评估。(C)2011 Elsevier Inc.保留所有权利。
Background and Purpose: Susceptibility weighted imaging (SWI) is sensitive to deoxyhemoglobin and blood products such as hemosiderin in detecting microbleeds in the brain. However, there are no studies on SWI in the spine cord injury so far. The purpose of this study was to evaluate the role of SWI in detecting hemorrhage in acute cervical spinal cord injury (SCI).Materials and Methods: Twenty-three patients with a history of acute cervical spine trauma were studied. High-resolution SWI, gradient-echo (GRE) T2* weighted-image (T2*WI) and conventional magnetic resonance imaging (MRI) were performed on all patients within 15 days of the onset of injury. On the basis of the MRI findings, the patients were classified into four patterns: normal cord, spinal cord edema, spinal cord contusion and spinal cord hemorrhage. Quantitative analysis was performed by calculating and comparing the signal ratio of the hemorrhage to normal spinal cord on the same slice of T2*WI and SWI. All patients were clinically evaluated in follow-up. Twenty volunteers were also scanned as a control group.Results: Out of 23 patients with a history of acute cervical spine trauma, 4 patients showed normal spinal cord on both conventional MRI and SWI, 8 had only spinal cord edema and 5 had contusion on conventional MRI, but SWI showed hemorrhage in 2 of the 5 patients with spinal contusion on conventional MRI; the other 6 patients had intraspinal hemorrhage on conventional MRI, and SWI proved hemorrhage in all these 6 patients. There was a significant difference between the signal ratios of hemorrhage to normal tissue on T2*WI and SWI (Z=2.34, P=.02).Conclusion: Susceptibility weighted imaging is more sensitive than conventional MRI in detecting hemorrhage in acute cervical SCI. This technique could prove to be a useful tool in the routine evaluation of cervical SCI patients. (C) 2011 Elsevier Inc. All rights reserved.