创伤性颈脊髓损伤患者华勒氏变性的磁共振成像研究
Wallerian degeneration in patients with traumatic cervical spinal cord injury:a magnetic resonance imaging study
袁媛 1周红俊 1卫波 1丛欣莹 2刘根林 1郑樱 1郝春霞 1张缨 1王一吉 1康海琼 1逯晓蕾 1蒙倩茹1
作者信息
- 1. 首都医科大学康复医学院,北京市 100068;中国康复研究中心北京博爱医院,脊髓损伤康复科,北京市 100068
- 2. 首都医科大学康复医学院,北京市 100068;中国康复研究中心北京博爱医院,影像科,北京市 100068
- 折叠
摘要
目的 探讨创伤性颈脊髓损伤患者脊髓华勒氏变性(WD)的磁共振成像(MRI)信号特点.方法 回顾性分析2015年1月至2021年12月在北京博爱医院脊髓损伤康复科住院康复的191例创伤性颈脊髓损伤患者的临床资料,对常规颈椎MRI的矢状位及轴位T2加权像(T2WI)进行影像学评估,将其分为WD组和非WD组.比较两组性别、年龄、损伤机制、美国脊柱损伤协会残损分级(AIS)、神经平面、伤后获得MRI的时间差等,并分析WD在脊髓的背柱区(DC)、外侧脊髓丘脑束区(ST)和外侧皮质脊髓束区(CS)的信号特点.结果 115例(60.2%)出现WD.WD组与非WD组年龄、损伤机制、AIS的等级分布和伤后获得MRI时间差有显著性差异(Z>3.820,χ2>9.104,P<0.05).WD组中,在损伤部位的上方,DC、ST的WD发生率分别为100%和87%;在损伤部位的下方,CS的WD发生率为35.7%.根据WD信号出现的方式将其分为3组,只出现DC变化的15例(13%),DC合并ST发生变化为59例(51.3%),DC、ST、CS 3个位置均有变化的41例(35.7%).3组间伤后获得MRI的时间差有显著性差异(H = 90.794,P<0.05),3组间AIS等级分布无显著性差异(P>0.05).结论 创伤性颈脊髓损伤患者的常规MRI检查T2WI可检测到WD信号,且WD的发生与伤后时间存在关联.
Abstract
Objective To explore the signal characteristics of Wallerian degeneration(WD)of the spinal cord in patients with trau-matic cervical spinal cord injury.Methods A retrospective analysis was conducted.From January,2015 to December,2021,the clinical data of 191 pa-tients with traumatic cervical spinal cord injury in Beijing Boai Hospital were included.According to sagittal and axial T2-weighted images(T2WI)of routine cervical magnetic resonance imaging(MRI),the patients were divid-ed into WD group and non-WD group.The gender,age,mechanism of injury,American Spinal Injury Associa-tion Impairment Scale(AIS),neurological level,and time interval to obtain MRI after injury were compared be-tween two groups.The characteristics of WD in dorsal column(DC),lateral spinothalamic tract(ST)and lateral corticospinal tract(CS)were analyzed.Results A total of 115 cases(60.2%)showed WD.There were significant differences in age,mechanism of injury,AIS grade,and time interval to obtain MRI after injury between two groups(Z>3.820,χ2>9.104,P<0.05).In WD group,the occurrence rates of WD in DC and ST above the injury site were 100%and 87%,respectively.Below the injury site,the occurrence rate of WD in CS was 35.7%.Based on the pattern of WD signal appearance,three groups were identified:15 cases(13%)had only DC signal changes,59 cases(51.3%)had changes in both DC and ST,and 41 cases(35.7%)had changes in all the three locations(DC,ST and CS).There was significant dif-ference in the time interval to obtain MRI after injury(H = 90.794,P<0.05)among three groups,while there was no significance in AIS grade(P>0.05).Conclusion Routine MRI examination with T2WI could detect WD signals in patients with traumatic cervical spinal cord injury,and the occurrence of WD is associated with post-injury time.
关键词
创伤性颈脊髓损伤/华勒氏变性/磁共振成像/美国脊柱损伤协会残损分级Key words
traumatic cervical spinal cord injury/Wallerian degeneration/magnetic resonance imaging/American Spinal Injury Association Impairment Scale引用本文复制引用
基金项目
国家重点研发计划(2020YFC2007505)
出版年
2024
国家科技期刊平台
NSTL
万方数据