자기공명영상과 외상성 및 퇴행성 경추질환의 수술적 적응점

Abstract

We undertook a retrospective analysis of 20 patients admitted to the Department of Neurosurgery, Dongsan Medical Center, Keimyung University, utilizing Magnetic Resonance Imaging(MRI) to make diagnosis and surgical indication of traumatic and degenerative cervical spine lesions. All patients were taken T1 Weighted Image(T1WI), T2 Weighted Image(T2WI) and Gradient echo on 2.0 Tesla unit. Pre-and postoperative were obtained in 4 cases with degenerative lesion. All patients could be evaluated the extent and degree of soft tissue injury including intramedullary contusion or hemorrhage, acute or chronic disc herniation, osteophytes, cord compression, epidural/paravertebral hematoma, ligamentous avulsion, fractures and malalignment. High-signal-intensity (HSI) was observed on T2WI in 10 patients with myelopathy. HSI diminished postoperatively in the patients who improved clinically, and remained the same in one case whose conditions remained unchanged after decompression. Preliminary experience with Magnetic Resonance Imaging(MRI) in the evaluation of traumatic and degenerative cervical spine lesions reveal many advantages over the computed tomoography, plain radiographs and myelography. Furthermore, HSI of the spinal cord produced by compressive lessions appears to be an important indicator for predicting prognosis.

본 예비 임상연구를 통해 다음과 같이 요약할 수 있을 것으로 생각된다. 1) MRI기기, 영상기법, 대조기법의 발전으로 경추부에서는 외상성이나 퇴행성척추질환의 진단과 치료결정에 일차적 검사로 침습적(invasive) 검사인 척수조영술과 척추 CT를 MRI로 대치할 수 있을 것으로 생각된다. 2) 척수병증이 주 증상인 경우 수술 전 후에 T2 WI MRI 검사가 필요하며 예후 예측 인자로써 T2 WI의 HSI가 이용 될 수 있을 것으로 생각되며 지속적인 추시가 사료된다.