钝性颈椎韧带损伤的影像学:弥合神经放射学和神经外科医生之间的差距

Q4 Medicine Neurographics Pub Date : 2023-04-01 DOI:10.3174/ng.2100054
A. Prabhu, M. Stanton, S. Bhuta
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引用次数: 0

摘要

在急性脊柱创伤的情况下,影像学可以描绘所有骨和软组织损伤,并有助于指导潜在的手术干预。CT是急性创伤的首选技术。然而,MR成像在评估创伤性脊柱损伤中是不可或缺的,特别是评估CT上看不到的椎间盘韧带结构。我们根据Arbeitsgemeinschaft für Osteosynthesefragen(AO)脊柱分类系统描述了颈椎损伤的关键成像参数及其对神经外科管理的影响。T2脂肪饱和矢状面和冠状面图像对评估颈椎韧带有价值。3T的MR成像提供了比1.5T更高的分辨率。AO脊柱损伤分类现在被广泛使用,并且更稳健,与MR成像的相关性更好。A型损伤可以保守治疗。B型损伤具有潜在的不稳定性。B1单独的骨损伤可以保守治疗。前部或后部张力带损伤(B2/B3型)是不稳定的,可考虑手术干预或晕圈固定。C型损伤具有明显的韧带损伤,通常需要手术治疗。识别关键的MR成像结果并使用AO脊柱分类系统和报告模板有助于弥合神经放射科医生和神经外科医生之间的知识差距,进而影响患者管理。学习目标:根据AO分类,了解颈椎损伤关键成像结果的细微差别:如何使用简单的MR成像报告模板或检查表最大限度地减少报告中的错误;采用公认的命名法和术语,消除偏见,确保与神经外科团队沟通的一致性;弥合神经放射科医生和神经外科医生在钝性颈椎损伤治疗方面的知识差距
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Imaging of Blunt Cervical Spine Ligamentous Injuries: Bridging the Gap between Neuroradiologists and Neurosurgeons
In a setting of acute spinal trauma, imaging delineates all osseous and soft-tissue injuries and helps to guide potential surgical intervention. CT is the technique of choice in the setting of acute trauma. However, MR imaging is integral in the assessment of traumatic spinal injury, specifically assessing discoligamentous structures otherwise not seen on CT. We describe the critical imaging parameters of cervical spine injuries in accordance with the Arbeitsgemeinschaft für Osteosynthesefragen (AO) Spine classification system and its impact on neurosurgical management. T2 fat-saturation sagittal and coronal images are valuable in assessing cervical spine ligaments. MR imaging at 3T offers superior resolution than 1.5T. The AO Spine classification for cervical spine injuries is now widely used and is more robust and correlates well with MR imaging. Type A injuries can be managed conservatively. Type B injuries are potentially unstable. B1 osseous injuries alone can be managed conservatively. Anterior or posterior tension band injuries (B2/B3 type) are unstable and are considered for surgical intervention or halo immobilization. Type C injuries have marked ligamentous injury and often require surgery. Identifying key MR imaging findings and using the AO Spine classification system and a reporting template helps bridging the knowledge gap between neuroradiologists and neurosurgeons, in turn influencing patient management.Learning Objectives: To understand the nuances of critical imaging findings of cervical spine injuries in accordance with the AO classification: how to minimize errors in reports using a simple MR imaging reporting template or a checklist; incorporating a universally accepted nomenclature and terminologies to remove bias and ensure consistency in communication with neurosurgical teams; and bridging the knowledge gap between neuroradiologists and neurosurgeons in the management of blunt cervical spinal trauma
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来源期刊
Neurographics
Neurographics Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
0.20
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0.00%
发文量
12
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