Experimental And Clinical Study Of Acute Spinal Cord Injury--High-field-strength MRI And MRS Study

Purpose:To evaluate the ability of high-field-strength MR and Proton magnetic resonance Spcetroscopy (¹H-MRS) for the application and diagnosis of spinal cord injury. To research the relationship within different MR imaging, pathological changes and neurologic deficition after spinal cord injuryMaterials and Methods:1.Build fluid-percussion spinal cord injury model. Twenty-three rabbits were divided into three groups: (five were control group,others were experimental group,each was nine).Once performed spinal cord injury model with the fluidpercussion equipment, one day after injury followed with Travor assessment.2.MIRI examination. Magnetom Vision type MR, MR scan use turbo spin echo sequence and fitting with small-flexible circle. MR scan refers to the four stages:within twenty-four hour, within three days, within seven days also compared with Travor assessment and pathologic examination.3.Pathologic examination each injury group within twenty-four, seventy-two hour, and seven-day. All rabbits were killed with over-dose-injection pentobarbital sodium, got the spinal cord for LIE section staining.4.Retrospectively select fifty-four cases of spine injury, all patients were underwent MR exam, MR scan use TI WI and T2WI turbo-SE sequence include both sagittal and cross section.5.To analysis edema and hemorrhage in spinal cord with characteristic MR imaging combined with clinical ASIA assessment, statistic the neurologic deficit with the abnormal signal range including length and width.6.Proton spectroscopy was applied for clinical exam, twenty-seven cases in total. Normal group were eight cases, nineteen were after spine trauma, there are eleven patient with spinal cord signal abnormal, and eight were only compressed either by fracture or disc. Normal group were examed C_4-6 spinal cord and diabasis of C₁ and bulbar, others were examed injuried spinal cord and also diabasis of C₁ and bulbar.7.The metabolic materials in Magnetic Resonance Spectroscopy comprizes Nacetyl-aspartate(NAA), Choline(Cho), Creatinine(Cr), Lactate(Lac). To calculate such peak area ratio: NAAICho, NAAICr, Cr/Cho and Lac/Cr. Statistics metabolic materials changes within each group.ResultsI.The MEP and Travor assement with MR imaging of experimental spinal cord injury were according. The injury between the two groups was evident.2.Experimental spinal cord injury with dynamic state MRI scan. In groupA, 24 hour after injury show the mixed signal, 72-hour later show spinal medullary canal and cavum subarachnoidale hyperaemia, seven day later there is liqluation and necrosis signal. In group B, 72 hour after injury can find the punctual signalraise, it spread followeing time.3.The comparison dynamic MRI and pathological change. The MIRI of these two group were in accord with to pathological change.4.MR findings in Spine trauma. It is helpful of high-field-strength MR to distinguish hemorrhage and edema after spinal cord injury.EDT2WI demonstrated hypointensity surrounded by hyperintensity or mixed singal intensity in sixteen cases with intramedullary hemorrhage. ^Also T2WI demonstrated focus high signal intensity in twelve patients with intramedullary edama.5.The research of relationship between various MR imaging and the severity of neurologic injury. CL) The severity of neurologic injury in intramedullary hemorrhage are much more than those in edema(P<0.0 1), ^JThe length of intramedullary edema in A-degree (2.39 ?0.36) and C-degree (0.84 ?0.05)of ASIA assessment are far more different (P<0.05) , but the width of edema are independent of neurologic injury(P>0.05) . ⁹MR can entirely evaluate soft tissue abnormal.6.The application of MRS used in clinical patients. (1Dm normal group, the raito of NAAICho, NAAICr, Cr/Cho, Lac/Cr between C46 spinal cord and diabasis of C1 and bulbar is no different (P>0.01) . OEight cases with traumatic spinal cord compressed were examed the injuried spinal cord and also diabasis of C1 and5bulbar,the result was only the ration of Lac/...