脊髓梗死的磁共振诊断初探

目的:探讨脊髓梗死的MRI诊断,评价其诊断价值.方法:对临床怀疑脊髓梗死的7例病例进行MRI检查,包括常规矢状位T1WI、T2WI、SPIR和轴位T1WI、T2WI,其中6例病例有增强扫描,5例有扩散加权序列.结果:脊髓梗死诊断7例:颈段3例,胸腰段4例.MR信号强度与发病时间、病程进展有关:发病3天内脊髓略肿胀,T1WI略低信号,T2WI略高信号,扩散为高信号,无明显强化.3～14 d病灶呈T1WI低信号,T2WI高信号,可有不同程度强化,扩散为高信号.2周后扩散为混杂信号.缓解期,病变受损范围可减少1～2个节段.结论:MRI可显示脊髓梗死的病变范围及受累部位,与临床结合,可早期诊断.

Preliminary MRI Study of the Diagnosis of Spinal Cord Infarction

Objective:To study the MRI findings and its value in the diagnosis of spinal cord infarction.Methods:MRI was performed in patients suspected of having spinal cord infarction.Pulse sequences used including sagittal plane:T_1WI,T_2WI,T_2WI/STIR;axial plane:T_1WI,T_2WI,some cases had contrast enhancement and DWI.Results:7 patients were diagnosed as spinal cord infarction.Among them,lesion located at the cervical level (n=3),thoracolumbar level (n=4).The MR signal intensities depended on the time period between onset and MR examination,the course and progress of the illness.Within three days after onset of the disease,cord swelling could be revealed,the lesion showed slightly hyper-intense on T_2WI,slightly hypo-intense on T_1WI,high signal intensity on DWI,no obvious contrast enhancement was shown.From 3 days to 2 weeks,the lesion was hyper-intense on T_2WI,hypo-intense on T_2WI,high signal intensity on DWI,with varied degree of contrast enhancement.After 2 weeks,mixed signal intensity was showed on DWI.At the remission stage,the extent of lesion could be reduced for 1~2 segments.Conclusion:The extent and location of spinal cord infarction could be depicted by MRI,correlation with clinical signs and symptoms,early diagnosis could be achieved.