ACUTE SPINAL-CORD INJURY - A STUDY USING PHYSICAL-EXAMINATION AND MAGNETIC-RESONANCE-IMAGING
ACUTE SPINAL-CORD INJURY - A STUDY USING PHYSICAL-EXAMINATION AND MAGNETIC-RESONANCE-IMAGING
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DOI：
10.1097/00007632-199003000-00002
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发表时间：
1990-03-01
期刊：
影响因子：
3
通讯作者：
HARRIS, JH
中科院分区：
文献类型：
--
作者：
BONDURANT, FJ;COTLER, HB;HARRIS, JH
对37例急性脊髓损伤患者进行了磁共振成像（MRI），采用T1和T2加权像。三种不同类型的MRI信号模式被检测到与这些脊髓损伤。使用这三种模式进行分类。I型，见于10例（27.0%）患者，表现出与急性椎管内出血一致的信号强度降低。II型，见于16例（43.2%）患者，表现出与急性脊髓水肿一致的明亮信号强度。III型，见于3例（8.1%）患者，表现为中心低信号和周围高信号的混合信号，与挫伤一致。其余8例患者MRI显示脊髓正常。所有37例患者均进行了入院神经病学评估，并根据Frankel分类和创伤运动指数（TMI）对其脊髓损伤进行了分类。平均伤后12.1个月，重新评估他们的神经功能。I型患者的Frankel分级没有改善，TMI改善最小，为32.1 - 42.4。相比之下，所有II型和III型模式至少改善了一个Frankel分类。II型TMI从70.8增至91.9，III型从37.3增至75.7。这份初步报告指出，脊髓损伤的模式，如MRI和神经功能恢复所确定的明显相关性。看来，MRI的能力，以帮助检查脊髓的条件将提供一种手段，预测神经功能恢复后，急性脊髓损伤。
Magnetic resonance imaging (MRI) was performed on 37 patients with acute spinal injury using T1- and T2-weighted images. Three different types of MRI signal patterns were detected in association with these spinal cord injuries. A classification was developed using these three patterns. Type I, seen in ten (27.0%) of the patients, demonstrated a decreased signal intensity consistent with acute intraspinal hemorrhage. Type II, seen in 16 (43.2%) of the patients, demonstrated a bright signal intensity consistent with acute cord edema. Type III, seen in three (8.1%) of the patients, demonstrated a mixed signal of hypointensity centrally and hyperintensity peripherally consistent with contusion. The remaining eight patients had normal cords by MRI. All 37 patients had an admitting neurologic assessment and classification of their spinal injury according to the Frankel classification and the Trauma Motor Index (TMI). At an average of 12.1 months postinjury, their neurologic function was reassessed. Patients with Type I patterns showed no improvement in their Frankel classification and minimal improvement in their TMI, 32.1 to 42.4. In comparison, all of the Type II and III patterns improved at least one Frankel classification. The Type II TMI increased from 70.8 to 91.9 and Type III from 37.3 to 75.7. This preliminary report indicates a distinct correlation between the pattern of spinal cord injury as identified by MRI and neurologic recovery. It appears that the ability of MRI to aid in examination of the condition of the spinal cord will offer a means of predicting neurologic recovery following acute spinal cord injury.