脊髓型颈椎病患者颈脊髓磁共振扩散张量成像的特点及临床意义

Characteristics and clinical significance of magnetic resonance diffusion tensor imaging of cervical spinal cord in patients with cervical spondylotic myelopathy

中文关键词:  脊髓型颈椎病  颈脊髓  磁共振成像  扩散张量成像

英文关键词:Cervical spondylotic myelopathy  Cervical spinal cord  Magnetic resonance imaging  Diffusion tensor imaging

中文摘要:

  【摘要】 目的：观察脊髓型颈椎病（cervical spondylotic myelopathy，CSM）患者磁共振扩散张量成像（diffusion tensor imaging，DTI）的特点，探讨DTI在评价颈脊髓慢性损伤的价值。方法：纳入2011年2月~2015年2月间收治的20例CSM患者（CSM组），并选择年龄匹配的42例健康志愿者作为对照组，均行颈椎磁共振DTI，测量CSM组病变节段以及对照组C2/3~C6/7节段颈脊髓的表观弥散系数（apparent diffusion coefficient，ADC）、各向异性分数（fractional aniostropy， FA）。比较对照组不同节段颈脊髓的ADC值和FA值，将CSM组和对照组颈脊髓的ADC值和FA值分别进行比较，并对CSM患者颈脊髓ADC、FA评分和颈椎改良JOA（mJOA）评分分别进行相关性分析。结果：对照组颈脊髓的ADC值自C2/3~C6/7节段呈上升趋势，而FA值呈下降趋势，C2/3节段颈脊髓的ADC值较C5/6和C6/7节段明显低，而FA值明显高（ADC：F=3.546，P=0.008；FA：F=13.82，P＜0.001）。CSM组颈脊髓的FA值与对照组比较显著性减小（P<0.001），而ADC值则显著性增加（P<0.001）。CSM组颈脊髓的ADC值与mJOA评分无显著相关性（r=-0.287，P=0.220），而颈脊髓的FA值与mJOA评分存在显著性正相关（r=0.359，P=0.005）。结论：CSM患者颈脊髓DTI与正常人群存在差异，其ADC值较正常人群升高，而FA值则明显降低；mJOA评分与FA值呈正相关。

英文摘要:

  【Abstract】 Objectives: To observe the characteristics of magnetic resonance diffusion tensor imaging(DTI) of the cervical spinal cord in patients with cervical spondylotic myelopahty(CSM), and to discuss the value of DTI for the chronic spinal cord injury. Methods: From February 2011 to February 2015, 20 patients with cervical spondylotic myelopathy were accepted and 42 age-matched healthy volunteers were included as a control group. Apparent diffusion coefficient(ADC) and fractional aniostropy(FA) values of the cervical spinal cord from C2/3 to C6/7 in the control group and in the CSM group were measured respectively. ADC and FA values of different segments in volunteers were compared. ADC and FA values of the cervical spinal cord in the two groups were compared respectively. ADC and FA values of the cervical spinal cord were made correlations with mJOA scores in CSM patients respectively. Results: ADC value showed an ascending trend from C2/3 to C6/7, while FA value showed a descending trend. ADC and FA values of C2/3 were significantly different from those of C5/6 and C6/7 respectively(ADC: F=3.546, P=0.008; FA: F=13.82, P＜0.001). ADC value of the cervical spinal cord in the CSM group showed significant increase while FA value showed significant decrease compared with that of the control group respectively(P<0.001). ADC value of the cervical spinal cord showed no linear correlation with mJOA score(r=-0.287, P=0.220), while FA value showed a significant linear correlation with mJOA score(r=0.359, P=0.005). Conclusions: ADC value of the cervical spinal cord in CSM patients shows a significant increase compared with that in healthy volunteers, while FA value shows a significant decrease. FA value shows a significant linear correlation with mJOA score.