颈髓弥散张量成像临床应用的初步探讨  

Preliminary Clinical Applications of DTI in Human Cervical Spinal Cord

作　　者：宋亭[1] 梁碧玲[2] 胡春洪[3] 沈君[2] 麦伟文[1] 黄穗乔[2] 

机构地区：[1]广州医学院第三附属医院放射科,广州510150 [2]中山大学附属第二医院放射科,广州510120 [3]苏州大学附属第一医院放射科,苏州215006

出　　处：《苏州大学学报（医学版）》2007年第3期403-406,F0002,共5页Suzhou University Journal of Medical Science

摘　　要：目的探讨弥散张量成像(diffusion tensor imaging,DTI)在颈髓中的应用价值。方法选取脊髓型颈椎病患者21例和20例正常志愿者。均行MRI常规序列和DTI扫描。DTI采用单次激发快速自旋回波EPI成像序列,取6个方向,b值取400 s.mm-2。使用感兴趣区技术测量:正常人4个不同水平(C2/3、C3/4、C4/5和C5/6)颈髓的表观弥散系数(apparent diffusion coefficient,ADC)和部分各向异性(fractional anisotropy,FA)值;和病例组病灶和正常颈髓节段的ADC和FA值。结果(1)正常颈髓在ADC图上信号均匀呈中等信号;在FA图上为高信号,在彩色张量图上为蓝色。颈髓4个不同节段的FA值有明显差别(F=159.24,P<0.001),以C2/3水平脊髓的FA值最高(0.85±0.03);但ADC没有明显差别(F=2.191,P>0.05)。(2)病例组:T2WI发现颈髓内异常信号9例,另外12例未见异常。而在彩色张量图上有16例信号异常,表现为正常蓝色颈髓中斑片状绿色异常信号影;病灶和正常区域颈髓间的ADC(t=-2.883,P=0.009)和FA(t=2.615,P=0.017)均有显著性差异。结论国人正常颈髓FA值约在C2/3水平最高,越往尾侧FA值越低,而颈髓4个节段ADC值则没有明显差别;DTI彩色张量图可以发现常规MRI所不能显示的异常改变;使用单次激发快速自旋回波EPI成像序列,取6个方向,b值取400 s.mm-2,DTI的图像质量令人满意。Objective To condcut preliminary study of the value of DTI（diffusion tensor imaging） in human cervical spinal cord. Methods Twenty-one patients suffering from cervical spondylotic myelopathy and twenty volunteers without any clinical symptoms underwent routine MRI and DTI examination. DTI was performed in six non-collinear directions with single-shot fast spin echo echo-planar imaging sequence（b value= 400 s·mm-2）. ADC（apparent diffusion coefficient）and FA（fractional anisotropy） values were measured by ROIs（regions of interest） in 4 different level segment spinal cord （C2/3, C3/4, C4/5, C5/6） in normal volunteers, in lesions and normal segmental spinal cord in clinical cases respectively. DTI original images were automatically processed by using IDL （Version 5.6） software to produce color tensor images. SPSS11.0 software for windows was used for t-test and one-way ANOVA analysis. The difference was considered statistically significant if P 〈 0.05. Results （1） For volunteers, cervical spinal cord exhibited intermediated signal intensity on ADC map, high signal intensity on PA map, and blue color on the colorized FA map. Four different level segment spinal cord, C2/3, C3/4, C4/5, C5/6, were analyzed and it was found that FA value between them had a significant difference by ANOVA, F = 159.24, P（0. 001, with the highest FA value （0.85 ＋ 0.03） of spinal cord segment of C2/3 level. However, ADC value between 4 segments had no significant difference（F=2. 191, P〉0.05）. （2）In patients of cervical spondylotic myelopathy, routine MRI T2WI showed abnormal signal in 9 cases, and showed no abnormal signal in 12 cases. In sixteen cases it was found that abnormal patchy green signal on colorized tensor maps appeared on the normal blue spinal cord. Also, in patients of cervical spondylotic myelopathy, there was significant difference in ADC and FA value between lesions and normal spinal cord （paired t test, for ADC, t = 2.88, P 〈 0.05, for FA, t = 2.62, P 〈 0.05）. Conc

关 键 词：脊髓 颈 磁共振成像 弥散张量成像 部分各向异性 表观弥散系数 

分 类 号：R814.4[医药卫生—影像医学与核医学]