陈维聪 万运 黄达保

摘要：目的：对比分析CT与MRI两种影像学检查方法在诊断脊柱外伤中的临床价值。方法：选取我院2018年3月-2021年3月就诊的脊柱外伤患者118例作为研究对象，在就诊前有明确的外伤史，并存在明显的临床症状，所有患者均进行CT和MRI检查。比较CT和MRI诊断的临床价值。结果：CT检查出113例脊椎骨折，MRI检查出116例脊椎骨折，两种方法检查脊椎骨折率的差异无统计学意义（P>0.05）。CT能够清晰辨别的椎体骨折线116个，MRI能够清晰辨别的椎体骨折线79个，椎体骨折线检出率差异具有统计学意义（P<0.05）。MRI在脊髓损伤、神经根损伤、前纵韧带损伤和后纵韧带损伤检出率（33.90%、85.00%、33.05%、32.20%）高于CT（22.03%、13.56%、5.08%、5.93%），差异具有统计学意义（P<0.05）。两组方法在软组织损伤检出率（50.00% vs 53.39%）方面差异无统计学意义（P>0.05）。结论：CT在椎体骨折线上显示清晰，MRI在脊髓损伤、神经根损伤、前纵韧带损伤和后纵韧带损伤方面诊断更为准确，两种诊断方法各有优势，临床根据目的选择或者联用诊断方法。

关键词：CT;MRI;脊柱外伤;脊髓损伤

中图分类号：R445.4文献标识码：BDOI：10？郾3969/j.issn.1001-0270.2021.05.06

The Clinical Value of CT and MRI Compared in the Diagnosis of Spinal Trauma

CHEN Wei-cong， WAN Yun， HUANG Da-bao

（Department of Radiology， Xinyi Peoples Hospital， Guangdong 525300， China）

Abstract： Objective： To compare and analyze the clinical value of CT and MRI in the diagnosis of spinal trauma. Methods： 118 patients with spinal trauma who visited our hospital from March 2018 to March 2021 were selected as the study subjects. They had a clear history of trauma before treatment and had obvious clinical symptoms. All patients underwent CT and MRI examinations. To compare the clinical value of CT and MRI diagnosis. Results： 113 cases of vertebral fractures were detected by CT and 116 cases by MRI. There was no significant difference in vertebral fracture rate between the two methods （P>0.05）.There were 116 vertebral fracture lines that could be clearly distinguished by CT and 79 vertebral fracture lines that could be clearly distinguished by MRI， and the difference in the detection rate of vertebral fracture lines was statistically significant （P<0.05）.The detection rate （33.90%、85.00%、33.05%、32.20%） of MRI in spinal cord injury， nerve root injury， anterior longitudinal ligament injury and posterior longitudinal ligament injury was higher than that of CT method （22.03%、13.56%、5.08%、5.93%）， and the difference was statistically significant （P<0.05）.The difference in the detection rate（50.00% vs 53.39%）of soft tissue injury between the two groups had no statistical significance（P>0.05）. Conclusion： CT is more accurate in the diagnosis of spinal cord injury， nerve root injury， anterior longitudinal ligament injury and posterior longitudinal ligament injury.

Key Words： CT; MRI; spinal trauma; spinal cord injury

脊髓損伤影响全球数百万人，仅在美国，约30人每天发生脊髓损伤，通常由机动车事故、跌倒以及运动等原因引起，而疾病也是导致脊髓损伤的风险之一。患者经历的功能丧失取决于损伤的脊柱节段和该节段损伤的范围和精确的解剖位置，有较高的致残率和致死率，给患者的生命健康带来严重威胁[1]。因此及时诊断脊柱损伤，并且判断损伤程度、损伤部位等重要信息对拟定个体化治疗方案具有重要意义，并且对后续远期康复和预后评估都十分重要。一般而言，X线是临床常采用的脊柱外伤诊断检查，但是X线难以详细诊断骨折，仅能提供粉碎骨折的骨折线，影响医生对疾病的判断和治疗，甚至导致部分患者错过最佳治疗时机[2]。随着……