MR扩散张量成像表观扩散系数和各向异性分数对不同病程颈脊髓压迫症的诊断价值

The diagnosis value of apparent diffusion coefficient and fractional anisotropy of MR-diffusion tensor imaging for different courses of cervical cord compression

中文关键词:  颈脊髓压迫症  MRI  MR扩散张量成像  表观扩散系数  各向异性分数

英文关键词:Cervical cord compression  MRI  MR-diffusion tensor imaging  Apparent diffusion coefficient  Fractional anisotropy

中文摘要:

  【摘要】 目的：探讨MR扩散张量成像（MR-diffusion tensor imaging，MR-DTI）表观扩散系数（ADC）和各向异性分数（FA）对不同病程颈脊髓压迫症的诊断价值。方法：2010年1月~2011年6月经MRI常规检查诊断为颈脊髓压迫症的患者50例，其中急性颈脊髓压迫患者15例（A组），均为外伤患者，在伤后72h内接受MRI检查；慢性颈脊髓压迫23例（B组），均为脊髓型颈椎病患者，病程超过6个月；慢性合并急性颈脊髓压迫12例（C组），均有超过6个月的脊髓型颈椎病病史，且本次MRI检查前72h内受到颈部外伤累及颈髓。15例健康志愿者为对照组（D组），MRI常规检查颈脊髓未见异常。4组均行MR-DTI检查，测量A、B、C组患者颈脊髓受压处及D组C5/6椎间盘平面脊髓的ADC和FA，并行组间比较。结果：A、B、C、D组的ADC分别为（0.712±0.241）×10-3mm2/s、（1.012±0.256）×10-3mm2/s、（0.812±0.125）×10-3mm2/s、（0.823±0.106）×10-3mm2/s，FA分别为0.401±0.098、0.472±0.095、0.496±0.172、0.541±0.158。A组ADC和FA与D组比较均明显降低（P<0.05）；B组FA与D组比较明显降低、ADC明显增高（P<0.05）；C组ADC与D组比较无显著性差异（P>0.05），FA值低于D组（P<0.05）。A组ADC及FA均低于B、C组（P<0.05）；B组ADC高于C组，FA低于C组，组间差异有显著性（P<0.05）。结论：MR-DTI的ADC及FA对不同病程颈脊髓压迫症有诊断价值。

英文摘要:

  【Abstract】 Objectives: To study the diagnosis value of apparent diffusion coefficient(ADC) and fractional anisotropy(FA) of MR-diffusion tensor imaging(MR-DTI) for different courses of cervical cord compression.Methods: 50 patients with cervical cord compression were involved in this study from January 2010 to June 2011. These patients were divided into 3 groups, group A: acute cervical cord compression group(n=15) underwent the cervical cord MRI within 72h after the injury; group B: chronic cervical cord compression group(n=23) had more than 6 months cervical myelopathy history; group C: chronic history with acute cervical cord compression group(n=12) had more than 6 months cervical myelopathy history and suffered from an acute cervical cord injury, and underwent the MR scan within 72h after the injury; group D included 15 healthy volunteers with normal MRI. All cases in 4 groups underwent MR-DTI.The values of ADC and FA in the compressed cervical cord in group A, B and C, and those at C5/6 in group D were meassured and compared.Results: The values of ADC in group A, B, C and D were (0.712±0.241)×10-3mm2/s, (1.012±0.256)×10-3mm2/s, (0.812±0.125)×10-3mm2/s and (0.823±0.106)×10-3mm2/s respectively, and the values of FA in group A, B, C and D were 0.401±0.098, 0.472±0.095, 0.496±0.172 and 0.541±0.158 respectively. Group A had significantly lower values of ADC and FA than group D(P<0.05); the FA decreased and ADC increased in group B compared with group D(P<0.05). The value of ADC had no change(P>0.05), but the value of FA decreased(P<0.05) in group C compared with group D. Group A had lower values of ADC and FA than group B and C（P<0.05）, and group B had higher value of ADC and lower value of FA than group C, which showed significant difference（P<0.05）. Conclusions: The ADC and FA under MR-DTI can determine different courses of cervical cord compression.