摘要
目的 探讨颈椎闭合性骨折脱位继发椎动脉损伤的机制及MRA诊断。方法 本组 95例颈椎闭合性创伤 ,男 76例 ,女19例 ,年龄 16～ 6 5岁 ,平均 34岁。所有患者接受颈椎MRI和椎动脉MRA检查 ,当椎动脉预期位置完全无血流成像 ,MRIT2 横断面上椎动脉内有高信号血栓影像时 ,即确诊为椎动脉阻塞。结果 本组 95例中 ,19例合并有椎动脉闭塞 ,均为单侧 ,左侧 9例 ,右侧 10例 ,其中颈椎骨折 5例 ,双侧小关节突脱位 6例 ,单侧小关节突脱位 7例 ,无放射影像异常的脊髓损伤 1例。 18例椎动脉损伤患者无任何症状 ,1例有轻度头昏、嗜睡。结论 椎动脉损伤易继发于有小关节突脱位的颈椎创伤 。
Objective To evaluate the mechanism and MRA diagnosis of vertebral artery injuries following closed cervical spine trauma.Methods There were 95 patients with closed cervical spine trauma.Of the patients,there were 76 males and 19 female patients,with an average age of 34 years (range,16-65 years).All patients underwent the MRI and magnetic resonance angiography (MRA) of the cervical spine.Traumatic thrombosis of a vertebral artery was diagnosed when two criteria were fulfilled:1.Absence of flow-related enhancement of the MRA images in the expected location of the vertebral artery.2.Identification of a hyperintense clot within the vertebral artery on the echo axial T 2 images.Results Complete absence of blood flow image due to disruption of the vertebral artery was demonstrated by MRA in 19 of the 95 patients.All happened unilaterally.There were 9 left vertebral artery occlusion and 10 right.Of the 19 patients with vertebral artery injuries,there were 5 cervical vertebral fracture,7 unilateral facet dislocation,6 bilateral facet dislocation,one spinal cord injury without radiographic abnormality.Eighteen patients did have any symptoms of vertebral artery insufficiency.One had slight dizziness.Conclusion Vertebral artery injuries may be easy to follow closed cervical spine Trauma.MRA is the most important prospective method of detection of this condition.
出处
《骨与关节损伤杂志》
2002年第6期401-403,共3页
The Journal of Bone and Joint Injury
关键词
颈椎
闭合性创作
椎动脉
核磁共振血管成像
诊断
Cervical spine
Closed trauma
Vertebral artery
Magnetic resonance angiography
