儿童脊髓损伤后脊髓萎缩的MRI特征以及与损伤平面的相关性

doi:10.3969/j.issn.1006-9771.2026.04.002

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (4): 387-392.doi: 10.3969/j.issn.1006-9771.2026.04.002

儿童脊髓损伤后脊髓萎缩的MRI特征以及与损伤平面的相关性

张赢心¹^,², 刘根林^3a^,⁴, 陈迪¹^,², 张红霞^3b^,⁴, 田益凡¹^,², 王一吉^3a^,⁴(), 敬洋⁵, 程瑞动⁶^,⁷, 张韶岷⁸, 姚佳烽⁹, 孙博¹⁰, 孙潇蒙¹^,²

¹ 中国康复科学所康复信息研究部，北京市 100068
² 世界卫生组织国际分类家族中国合作中心，北京市 100068
³ 中国康复研究中心北京博爱医院， a. 脊髓损伤康复科；b. 影像科，北京市 100068
⁴ 首都医科大学康复医学院，北京市 100068
⁵ 慧影医疗科技（北京）有限公司AI创新中心，北京市 100080
⁶ 浙江省康复中心，浙江杭州市 310024
⁷ 杭州医学院附属人民医院，浙江杭州市 310014
⁸ 浙江大学求是高等研究院，浙江杭州市 310058
⁹ 暨南大学物理与光电工程学院，广东广州市 510632
¹⁰ 西安理工大学机械与精密仪器工程学院，陕西西安市 710048

收稿日期:2025-06-11 修回日期:2025-12-01 出版日期:2026-04-25 发布日期:2026-05-06
通讯作者: 王一吉，E-mail： wangyijicrrc@foxmail.com
作者简介:张赢心(1999-)，女，汉族，北京市人，研究实习员，主要研究方向：康复信息、康复大数据、影像组学；
刘根林(1965-)，男，汉族，浙江义乌市人，博士，主任医师，主要研究方向：脊髓损伤康复。
王一吉(1982-)，男，汉族，湖南衡阳市人，博士，主任医师，主要研究方向：脊髓损伤康复。
基金资助:
中国康复科学所中央级公益性科研院所基本科研业务费项目(2023CZ-8)

MRI findings of spinal cord atrophy after spinal cord injury in children and their injury level

ZHANG Yingxin¹^,², LIU Genlin^3a^,⁴, CHEN Di¹^,², ZHANG Hongxia^3b^,⁴, TIAN Yifan¹^,², WANG Yiji^3a^,⁴(), JING Yang⁵, CHENG Ruidong⁶^,⁷, ZHANG Shaomin⁸, YAO Jiafeng⁹, SUN Bo¹⁰, SUN Xiaomeng¹^,²

¹ Department of Rehabilitation Information Research, China Rehabilitation Research Institute, Beijing 100068, China
² WHO Family of International Classifications Collaborating Centre, Beijing 100068, China
³ a. Spinal Cord Injury Rehabilitation Department; b. Imaging Department, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
⁴ Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
⁵ AI Innovation Center, Huiying Medical Technology (Beijing) Co., Ltd., Beijing 100080, China
⁶ Zhejiang Provincial Rehabilitation Center, Hangzhou, Zhejiang 310024, China
⁷ Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
⁸ Qiushi Institute of Advanced Research, Zhejiang University, Hangzhou, Zhejiang 310058, China
⁹ School of Physics and Optoelectronic Engineering, Ji'nan University, Guangzhou, Guangdong 510632, China
¹⁰ School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an, Shaanxi 710048, China

Received:2025-06-11 Revised:2025-12-01 Published:2026-04-25 Online:2026-05-06
Contact: WANG Yiji, E-mail: wangyijicrrc@foxmail.com
Supported by:
The Fundamental Research Funds for Central Public Welfare Research Institutes, conducted by China Rehabilitation Science Institute(2023CZ-8)

摘要/Abstract

摘要：

目的利用影像平台勾画影像并观察儿童脊髓损伤患者脊髓萎缩的MRI特点与临床诊断的相关性。

方法收集中国康复研究中心北京博爱医院2002年1月至2024年3月收治的儿童脊髓损伤患儿150例的影像，导入影像平台中，测量脊髓萎缩最严重横断面脊髓中间部分的前后径和横径，同时测量上一个正常节段脊髓的相关指标作为对照，提取影像组学特征值。收集患儿的性别、年龄、致伤原因、感觉平面、运动平面、脊髓损伤平面、损伤程度和病程等资料。

结果识别出脊髓萎缩81例(54%)，其中，美国脊髓损伤协会损伤分级(AIS) A级78例(96%)，AIS C级3例(4%)。脊髓萎缩部位上限与损伤平面、运动平面、感觉平面强相关(r > 0.8, P < 0.001)。

结论脊髓损伤患儿超过一半可能继发脊髓萎缩，其中绝大多数为完全性脊髓损伤；脊髓萎缩的上限与损伤平面相关。

关键词: 脊髓损伤, 儿童, 脊髓萎缩, 损伤平面, 影像组学

Abstract:

Objective To delineate imaging findings using an imaging platform and investigate the correlation between MRI characteristics of spinal cord atrophy and clinical diagnosis in children with spinal cord injury (SCI).

Methods Imaging data of 150 children with SCI admitted to Beijing Bo'ai Hospital, China Rehabilitation Research Center, from January, 2002 to March, 2024 were collected and imported into the imaging platform. The anteroposterior and transverse diameters of the middle part of the spinal cord at the cross-section with the most severe atrophy were measured, and the relevant indicators of the previous normal spinal cord segment were measured as controls; the radiomic features were extracted. Clinical data of the children including gender, age, cause of injury, sensory level, motor level, spinal cord injury level, injury severity and disease course were collected.

Results Spinal cord atrophy was identified in 81 cases (54%), among which 78 cases (96%) were American Spinal Injury Association Impairment Scale (AIS) grade A and 3 cases (4%) were AIS grade C. The upper boundary of the spinal cord atrophy site strongly correlated with the injury level, motor level and sensory level (r > 0.8, P < 0.001).

Conclusion More than half of children with SCI may develop secondary spinal cord atrophy, the vast majority of whom suffer from complete spinal cord injury; the upper boundary of spinal cord atrophy is correlated with the injury level.

Key words: spinal cord injury, children, spinal cord atrophy, injury level, radiomics

中图分类号:

R651.2

张赢心, 刘根林, 陈迪, 张红霞, 田益凡, 王一吉, 敬洋, 程瑞动, 张韶岷, 姚佳烽, 孙博, 孙潇蒙. 儿童脊髓损伤后脊髓萎缩的MRI特征以及与损伤平面的相关性[J]. 《中国康复理论与实践》, 2026, 32(4): 387-392.

ZHANG Yingxin, LIU Genlin, CHEN Di, ZHANG Hongxia, TIAN Yifan, WANG Yiji, JING Yang, CHENG Ruidong, ZHANG Shaomin, YAO Jiafeng, SUN Bo, SUN Xiaomeng. MRI findings of spinal cord atrophy after spinal cord injury in children and their injury level[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(4): 387-392.

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参考文献 20

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赋值	ISNCSCI平面	脊髓萎缩上限
1	C₁	C₁
2	C₂	C₂
3	C₃	C₃
4	C₄	C₄
5	C₅	C₅
6	C₆	C₆
7	C₇	C₇
8	C₈	T₁
9	T₁	T₂
10	T₂	T₃
11	T₃	T₄
12	T₄	T₅
13	T₅	T₆
14	T₆	T₇
15	T₇	T₈
16	T₈	T₉
17	T₉	T₁₀
18	T₁₀	T₁₁
19	T₁₁	T₁₂
20	T₁₂	L₁
21	L₁	L₂
22	L₂	L₃
23 24 25 26 27 28 29	L₃ L₄ L₅ S₁ S₂ S₃ S_4-5	L₄ L₅ S₁ S₂ S₃ S_4-5

病程	n
< 1个月	1
1~< 3个月	40
3~< 6个月	21
6~< 12个月	13
≥ 12个月	6

平面	n	平面	n
C₃	1	T₅	6
C₄	1	T₆	11
C₅	4	T₇	9
C₆	6	T₈	26
C₇	6	T₉	49
T₁	6	T₁₀	59
T₂	5	T₁₁	53
T₃	3	T₁₂	27
T₄	4	L₁	9

基本特征		萎缩	无萎缩	χ²值	P值
受伤年龄	< 8岁	61	45	1.830	0.176
受伤年龄	≥ 8岁	20	24		0.176
性别	男	16	17	0.518	0.472
性别	女	65	52		0.472
病因	外伤	63	53	0.020	0.888
病因	非外伤	18	16		0.888

变量	C_3-7	T_1-4	T_5-8	T_9-12
脊髓萎缩上限	5.2	9.3	15.1	16.3
损伤平面	5.0	10.0	16.0	18.0

儿童脊髓损伤后脊髓萎缩的MRI特征以及与损伤平面的相关性

MRI findings of spinal cord atrophy after spinal cord injury in children and their injury level

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