非常规MR检查技术在颈椎检查中的应用价值  

The role of dynamic MRI and angled sagittal MRI in the examination of cervical spine

作　　者：王淑丽[1] 张晓林[2] 马信龙[3] 张晴[1] 张晓光[1] 崔壮[4] 

机构地区：[1]天津市天津医院放射科,天津300211 [2]天津市天津医院脊柱外科,天津300211 [3]天津市天津医院骨科,天津300211 [4]天津医科大学

出　　处：《实用放射学杂志》2012年第11期1768-1773,共6页Journal of Practical Radiology

摘　　要：目的探讨非常规MR检查技术（动态MRI及斜矢状MRI）在颈椎检查中的应用价值。方法随机选取门诊就诊并能耐受动态MR检查的32例颈椎病患者及颈部无不适症状的志愿者15例行常规MRI及动态T2WI（过屈-过伸位）、全部志愿者及18例颈椎病患者行斜矢状T2wI；分析对照组与颈椎病组颈椎活动度间差异性；确定中立位与过屈-过伸位MRI中Ⅲ级椎管狭窄的显示率；主观评价斜矢状MRI显示椎间孔形态的满意程度及判断椎间孔狭窄的能力。结果对照组颈椎活动度大于颈椎病组，其中C4／5和C6／7水平差异显示统计学意义；颈椎病组过屈、中立及过伸位显示Ⅲ级椎管狭窄的节段数分别为9、17个和40个，分别，占全部节段数的（32×5）的5．63％、10.63％、25．00％，其间差异有统计学意义，过伸位检查的临床意义更大。斜矢状MR图像直观显示椎间孔形态，影像医师与临床医生的椎间孔狭窄判定能力的观察者间相关性佳（k=0．943）。结论非常规MR检查技术能显示早期颈椎失稳、直观判定椎间功能单位退变形成的动态性椎管狭窄，有效定位病变责任节段，反映脊髓嵌压的程度及直观显示椎间孔的立体形态并判断椎间孔受压（狭窄）的程度，该非常规颈椎MR检查技术作为颈椎常规MR检查的补充手段，显示了有价值的应用前景。Objective To evaluate the role of dynamic MRI and angled sagittal MRI in the examination of cervical spine. Methods Conventional MRI and dynamic T2WI were performed in 32 outpatients with cervical spondylosis who could tolerate dynamic MR and in 15 younger volunteers1 and angled sagittal Tz WI was performed in all voluneers and 18 of those patients. The functional spine unit at lower cervical spine and the overall sagittal alignment （C2--7） were measured. The correlations between normal control group and cervical spondylosis group were analysed as well. The rate of the grade III canal stenosis was ascertained among neutral and flexion-extension MRI. Subjective evalution was performed to determine the ablity to display the cervical foramen morphous and to dignose foraminal stenosis. Results The overall cevical mobility and segmental mobility in normal control group were lager than those in cervical spondylosis group, and significant differences were found at C4--5 and C6--7 segment. On flexion, neutral and ex tension MR imaging, the segmental numbers of grade III canal stenosis were nine （5.63%）, 17 （10.63%） and 40 （25.00%）, re spectively. Significant differences were found and extension MR imaging had more clinical value. Angled sagittal MRI could be uti- lized to display cervical foraminal morphous and interobserver agreement in the diagnosis of the foraminal stenosis was almost perfect （k= 0. 943 ）. Conclusion The diagnosis of early stage of instability at cervical spine, and confirmation of the dynamic changes of canal stenosis caused by degeneration of the functional cervical spine can be made by means of kinematic MRI. Meanwhile, it is also possible to locate the responsible segment for patients＇ signs and symptoms and to determine the extent of functional cord impinge-merit, The imaging features of cervical foramen and the evidence of foraminal stenosis can be evaluated by means of angled sagittal MRI. Kinematic MRI and angled sagittal MRI, as additional imaging techniques following c

关 键 词：磁共振成像 颈椎 

分 类 号：R445.2[医药卫生—影像医学与核医学] R323.1[医药卫生—诊断学]