神经根型颈椎病的影像学诊断及神经根障碍的相关性研究  

Imaging Diagnosis of Nerve-Root-type Cervical Spondylosis and the Correlative Study on the Nerve Root Disturbance

作　　者：郭会利[1] 张敏[1] 孔凡国[1] 水根会[1] 王锐[1] 

机构地区：[1]河南省洛阳正骨医院影像中心,河南洛阳471002

出　　处：《实用放射学杂志》2008年第4期442-444,471,共4页Journal of Practical Radiology

摘　　要：目的探讨神经根型颈椎病的影像学诊断价值并进行神经根障碍的相关性研究。方法对188例经临床证实且影像学资料完整的神经根型颈椎病进行回顾分析,比较其CR、CT及MRI的影像学特点并结合临床特征分析神经根障碍的相关因素。结果(1)CR6位片可以显示颈椎的整体表现:正侧位及功能位显示颈椎生理曲度改变122例(占64.9%),椎间隙变窄96例(占51.2%),椎体滑动或失稳49例(占26.1%);双斜位显示椎间孔变小或狭窄87例(占46.3%),Luschka关节增生82例(占43.2%)。(2)CT显示Luschka关节及椎间关节骨赘76例(占40.4%),显示椎间盘突出及软骨结节钙化80例(占42.6%),黄韧带肥厚或钙化66例(占39.8%)。(3)MRI显示椎间盘变性、突出105例(占55.8%),黄韧带肥厚或钙化51例(占27.1%),神经根及脊髓受压69例(占36.7%),脊髓水肿或变性23例(占12.2%)。结论神经根型颈椎病的神经根障碍与影像学表现密切相关,综合分析影像学资料及临床特征对该病的早期诊断、早期治疗有重要价值。Objective To explore the value of imaging diagnosis of nerve - root - type cervical spondylosis （NRTCS） and to study the relative factors to the nerve root disturbance. Methods 188 cases of NRTCS clinically proved and with complete imaging data were retro- spectively analyzed. The imaging characteristics of CR,CT and MRI of NRTCS were compared and the relative factors to the nerve root disturbance were analyzed in combination with the clinical characteristics. Results ①CR films in six - position could show the whole expression of the cervical spine. The anterior - posterior and functional position CR showed the physiological curvature change in 122 （64.9% ） , narrowing of intervertebral space in 96 （51.2% ） and vertebral - body unstability or slide in 49 （26.1% ）. The oblique CR showed the inter- vertebral -foramen lessening or narrowing in （26.1% ）and Luschka -or intervertebral -joint osteophyte in 82（43.2% ） ;②CT scans showed Luschka - or intervertebral -joint osteophyte in 76 （ 40.4% ） , disc herniation and calcification of cartilage nodus in 80 （42.6% ） and hypertrophy or calcification of ligamenlum flavum in 66 （39.8% ） ; ③MRI showed intervertebral - disk degeneration and protrusion in 105 （55.8% ） ,hypertrophy or calcification of ligamentum flavum in 51 （27.1% ） ,the nerve root and spinal cord compressed in 69 （36.7% ） and edema or degeneration of spinal cord in 23 （12.2% ）. Conclusion The nerve root disturbance is closely correlated with the imaging appearances in NRTCS. It is of importance in early diagnosis and treatment for NRTCS to analyse synthetically the imaging data and clinical characteristics.

关 键 词：颈椎 颈椎病 神经根 计算机X线摄影 体层摄影术 X线计算机 磁共振成像 

分 类 号：R681.55[医药卫生—骨科学] R814.42[医药卫生—外科学]