磁共振SPACE-STIR序列扫描对骶骨骨折合并骶神经损伤的诊断价值

Value of MRI SPACE-STIR sequence in determination of sacral fracture complicated with sacral nerve injury

中文关键词:  骶骨骨折  骶神经损伤  磁共振成像  SPACE-STIR序列

英文关键词:Sacral fracture  Sacral nerve injury  MRI  SPACE-STIR sequence

中文摘要:

  【摘要】 目的：探讨磁共振SPACE-STIR序列扫描对骶骨骨折合并骶神经损伤的诊断价值。方法：2009年1月~2010年12月我院收治骶骨骨折合并骶神经损伤患者7例，均有骶神经损伤的相应症状和体征，术前均行腰骶部X线片、CT检查及3．０T磁共振常规平扫与SPACE-STIR序列扫描检查，并行手术治疗。对7例患者术前的腰骶部磁共振常规扫描图像、SPACE-STIR序列扫描图像进行回顾性对比分析。结果：术前根据临床症状和体征诊断为骶神经损伤，其中S1神经根损伤5例，S2神经根损伤２例。术前X线片、CT检查均诊断为骶骨骨折,Denis Ⅱ型5例，Ⅲ型2例，但不能显示有无神经根损伤。术前磁共振常规平扫不能直接显示骶神经根损伤；磁共振SPACE-STIR序列扫描显示骶神经根中断2例，骶神经根受推压移位3例，骶神经根水肿增粗5例，诊断为S1神经根损伤6例，S2神经根损伤1例，其中S1、S2神经根断裂各1例。手术证实S1神经根损伤6例，S2神经根损伤1例，其中S1、S2神经根断裂各1例。SPACE-STIR序列扫描诊断与手术诊断的符合率为100%。结论：3．０T磁共振SPACE-STIR序列扫描可直观显示骶骨骨折引起的骶神经损伤。

英文摘要:

  【Abstract】 Objective：To investigate the diagnostic value of MRI SPACE-STIR sequence in determination of sacral fracture complicated with sacral nerve injury.Method：7 patients with sacral fracture and sacral nerve deficit from January 2009 to December 2010 were reviewed retrospectively.All cases presented with sacral nerve injury.X-ray，CT，MRI common scan and scan with SPACE-STIR sequence were performed preoperatively.After operation，the clinical data，routine scan images and images from SPACE-STIR sequence were analyzed retrospectively.Result：According to clinical symptoms and physical signs，5 cases had S1 nerve root injury，while 2 cases had S2 nerve root injury.Sacral fracture was determined by X-ray and CT scan，but sacral nerve injury could not be confirmed based on radiographic findings，even MRI could not do so.The preoperative MRI SPACE-STIR sequence showed rupture of sacral nerve root in 2 cases，compression and displacement of sacral nerve in 3 cases，and edema of sacral nerve in 5 cases；and S1 injury in 6 cases，while S2 injury in 1 cases.6 cases with S1 injury and 1 case with S2 injury were confirmed by operation，of these，there were 1 S1 nerve rupture and 1 S2 nerve rupture.The concordance rate between MRI SPACE-STIR sequence and operation in determining sacral nerve deficit was 100%.Conclusion：The 3T MRI SPACE-STIR sequence can directly exhibit sacral nerve injury due to sacral fracture.