3.0T MR扩散张量成像在脊髓型颈椎病诊断中的应用  

The Application of MR Diffusion Tensor Imaging in the Diagnosis Cervical Spondylotic Myelopathy in 3.0T

作　　者：刘秀香[1,2] 高思佳[1] 袁逍[1] 戚喜勋[1] 程钢[2] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001 [2]北京老年医院放射科,北京100095

出　　处：《中国医学影像学杂志》2011年第8期569-574,共6页Chinese Journal of Medical Imaging

基　　金：辽宁省科技厅自然科学基金(项目编号:2010225034);辽宁省教育厅科学技术研究项目基金(项目编号:L2010696)

摘　　要：目的探讨3.0TMR扩散张量成像(DTI)作为定量分析方法在脊髓型颈椎病诊断中的临床价值。资料与方法对10名健康志愿者(对照组)和60例脊髓型颈椎病患者(颈椎病组)行颈髓DTI研究,根据临床症状将颈椎病组分为轻度组、中度组、重度组和严重组,每组分别为18例、18例、12例、12例;另根据T1WI和T2WI颈髓信号类型,将颈椎病组分为N/N组(T1WI、T2WI均无信号异常)、N/H组(T1WI无信号异常,T2WI高信号)、L/H组(T1WI呈低信号,T2WI呈高信号),分析颈髓表观弥散系数(ADC)、分数各向异性(FA)、纵向弥散系数(λ1)、横向平均弥散系数(λ┷)及平均弥散系数(MD)的特征。结果颈椎病组中的轻度、中度、重度及严重组FA值较对照组低(F=64.565,P=0.0001),λ1值、λ┷值、MD值较对照组高(F=3.176,P=0.016;F=5.754,P=0.0001;F=4.366,P=0.003),ADC值与对照组比较差异无统计学意义(F=0.580,P=0.678);颈椎病组中的N/N组、N/H组、L/H组ADC值、λ┷值较对照组高(F=2.768,P=0.049;F=3.96,P=0.012),FA值较对照组低(F=10.387,P=0.0001),λ1值、MD值与对照组比较差异无统计学意义(F=2.322,P=0.083;F=2.286,P=0.087)。结论 FA、λ┷值是检测脊髓型颈椎病微结构变化的较敏感指标。Purpose To explore the value of diffusion tensor imaging （DTI） as a quantitative tool in cervical spondylotic myelopathy with 3.0T MR. Materials and Methods A total of 60 patients with cervical spondylotic myelopathy and 10 healthy volunteers were performed MR and DTI by using a 3.0T MR scanner, According to clinical symptom, sixty patients were divided into 4 groups, 18 mild, 18 moderate, 12 severe and 12 serious; According to the type of spinal cord lesion signal on T2WI and T1WI, they were divided into 3 groups, Groups A had no signal abnormality on T1WI and T2WI, Group B had high signal on T2WI, Group C had low signal on T1WI, while have high signal on T2WI. And then analyze apparent diffusion coefficient （ADC）, fractional anisotropy （FA）,λ1, λ┷and mean diffusivity （MD） values in the study. Results FA of mild, moderate, severe, serious group were significantly lower than that of control group （F = 64.565, P = 0.0001）, λ1,λ┷ and MD were significantly higher than those of control group （F= 3.176, P = 0.016; F= 5.754, P = 0.0001; F = 4.366, P = 0.003）, and ADC showed no difference compared with that of control group （F = 0.580, P = 0.678）; ADC and λ┷ in group A, group B and group C were significantly higher than those of control group （F = 2.768, P = 0.049; F = 3.96, P = 0.012）, FA was significantly lower than that of control group （F= 10.387, P = 0.0001）, λ┷ and MD showed no difference compared with those of control group （F = 2.322, P = 0.083; F = 2.286, P = 0.087）. Conclusion FA and λ┷ values are sensitive factors for evaluating cervical spinal cord damage in cervical spondylotic myelopathy.

关 键 词：颈椎 脊柱疾病 磁共振成像 弥散 诊断 

分 类 号：R681.531[医药卫生—骨科学]