MRI扩散张量成像在脊髓型颈椎病中的诊断价值#br#

doi:10.3969/j.issn.1007-3205.2020.02.015

摘要/Abstract

摘要： ［摘要］
目的探索MRI扩散张量成像检查在脊髓型颈椎病诊断中的价值。
方法纳入脊髓型颈椎病患者37例，均接受颈前路减压植骨融合内固定手术。根据术前脊髓T2WI信号比值（signal intensity ratio，SIR）分为3组：A 组11例， SIR＜1.32；B组12例，SIR 1.32~1.68；C组14例， SIR＞1.68。比较3组临床资料、FA值、日本矫形外科协会（Japanese Orthopaedic Association,JOA）评分和细化肢体功能评价。应用 Pearson检验分析JOA评分与FA值的相关性。
结果 3组均顺利完成手术。3组间手术时间、出血量、脑脊液漏发生率差异均无统计学意义（P＞0.05）。C组FA值低于A组和B组（P＜0.05）。术前和随访时，C组JOA评分低于A组和B组，3组随访时JOA评分高于术前，C组JOA评分改善率低于A组（P＜0.05）。术前和随访时，C组正常步长 6 m行走时间长于A组和B组，3组随访时正常步长 6 m行走时间短于术前（P＜0.05）。术前，B组最大步长6 m行走时间长于A组，C组最大步长6 m行走时间长于A组和B组。随访时，C组最大步长6 m行走时间长于A组，3组随访时最大步长6 m行走时间短于术前（P＜0.05）。术前，C组5次连续坐起时间长于A组和B组，随访时，B组5次连续坐起时间长于A组，C组5次连续坐起时间长于A组和B组，3组随访时5次连续坐起时间短于术前（P＜0.05）。术前和随访时，C组10 s连续握松拳次数少于A组，3组随访时10 s连续握松拳次数多于术前（P＜0.05）。术前JOA评分与FA值呈显著正相关，术后JOA评分改善率与FA值之间亦呈显著正相关（P＜0.05）。
结论 FA值可以作为髓内SIR显著升高脊髓型颈椎病患者的诊断指标；FA值与术后临床疗效密切相关。

关键词: 颈椎病, 脊髓T2WI信号比值, 弥散磁共振成像

Abstract: ［Abstract］Objective To explore the diagnosis value of diffusion tensor imaging in patients with cervical spondylotic myelopathy.
Methods Thirty-seven patients with cervical spondylotic myelopathy were recruited in this study and anterior cervical discectomy and fusion were performed in all patients. According to preoperative different degree of signal intensity ratio(SIR), patients were divided into three groups: 11 cases in group A SIR<1.32, 12 cases in group B SIR 1.32-1.68, 14 cases in group C SIR>1.68. Clinical information, FA value, Japanese Orthopaedic Association(JOA) scores and detailed limb function scores were collected to compared among three groups. The correlation between JOA scores and FA value was identified by Pearson correlation analysis.
Results Operations were successfully performed in all patients of three groups. There was no significant difference in surgical time, bleeding, rate of cerebrospinal fluid leakage among three groups(P＞0.05). The FA value was lower in group C than in group A and B(P＜0.05). JOA score was higher in last follow-up visit than preoperative in three groups, while it was lower in group C than group A and B at both preoperative and last follow-up visit. The JOA scores improvement rate was lower in group C than group A(P＜0.05). Walking time of 6 m of normal step was shorter in follow up than preoperative in three groups(P＜0.05), while it was longer in group C than group A and B at both preoperative and follow up. Walking time of 6 m of maximum step was longer in group B than group A before operation and at last follow-up visit, it was longer in group B than group A. In three groups, walking time of 6 m of maximum step was shorter at last follow-up visit than preoperative(P＜0.05). Before operation, five consecutive sitting time was longer in group C than group A and B. At last follow-up visit, five consecutive sitting time in group B was longer than group A and it was longer in group C than groups A and B. Five consecutive sitting time was shorter in last follow-up visit than preoperative in three groups(P＜0.05). In three groups, times of continuously hold loose fist in 10 s was greater at last follow-up visit than preoperative(P＜0.05), while at preoperative and last follow-up visit, times of continuously hold loose fist in 10 s was less in group C than group A. There was positive correlation between preoperative JOA scores(P＜0.05), JOA scores improvement rate(P＜0.05) and FA value.
Conclusion FA value shows satisfactory diagnosis value in cervical spondylotic myelopathy patients with increased SIR in cervical spinal cord. FA value is closely related to clinical outcomes after surgery.

Key words: cervical spondylosis, signal intensity ratio of T2WI in spinal cord, diffusion magnetic resonance imaging

李明，高显达，丁文元，杨大龙，孙家元，马雷*. MRI扩散张量成像在脊髓型颈椎病中的诊断价值#br#[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.02.015.

LI Ming, GAO Xian-da, DING Wen-yuan， YANG Da-long, SUN Jia-yuan, MA Lei*. Diagnostic value of DTI in cervical spondylotic myelopathy[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.02.015.

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MRI扩散张量成像在脊髓型颈椎病中的诊断价值#br#

Diagnostic value of DTI in cervical spondylotic myelopathy

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