平山病患者的中立位MRI表现及诊断意义  

Neutral Position MRI Features in Patients with Hirayama Disease and Its Diagnostic Significance

作　　者：李杰[1] 张文明[1] 林建华[1] 陈小荣[2] 王柠[3] 张立群[1] 李文波[1] 

机构地区：[1]福建医科大学附属第一医院骨科,福州350005 [2]福建医科大学附属第一医院影像科,福州350005 [3]福建医科大学附属第一医院神经科,福州350005

出　　处：《临床放射学杂志》2014年第12期1906-1909,共4页Journal of Clinical Radiology

摘　　要：目的探讨中立位MRI对平山病的诊断意义。方法选取确诊的平山病患者37例,平均就诊年龄20.0岁（15-27岁）。选取同期招募志愿者37例,平均年龄20.8岁。所有患者和志愿者均行颈椎屈曲位和中立位MRI检查。观察中立位影像学各种表现并选出具有高度诊断价值指标。结果失连接现象对平山病诊断的敏感性为94.6%,特异性为83.8%,阳性预测率为85.4%,阴性预测率为93.9%,两组间差异有统计学意义（OR=90.4,95%CI 16.991-481.135）。下颈椎中立位MRI上正中矢状位C5、C6椎体中线平面上脊髓萎缩对于平山病的诊断也具有较高诊断价值。结论失连接现象和正中矢状位C5、C6椎体中线平面上脊髓萎缩可协助诊断平山病。Objective To evaluate neutral position MRI findings in patients with Hirayama disease and to discuss its diagnostic significance. Methods A total of 37 patients （study group） with confirmed Hirayama disease, who were encountered at authors＇ hospital during the period from June 2006 to May 2013, were enrolled in this study. The mean age of hospitalized patients was 20.0 years （ range 15 - 27 years）. Other 37 volunteers （ mean age of 20.8 years） recruited during the same period were used as the control group. Cervical MRI scanning at flexed and neutral position was performed in all participants. Different imaging signs, focusing on the loss of attachment （LOA）, cervical curvature change, localized lower cervical cord atrophy and signal changed, were evaluated; and those signs that carried high diagnostic value were selected. Results LOA was observed in 35 cases. The diagnostic sensitivity, specificity and positive predictive rate of LOA for Hirayama disease were 94.6% , 83.8% and 93.9% respectively（ OR = 90.4,95% CI 16. 991 - 481. 135 ）. The differences in the diagnostic sensitivity, specificity and positive predictive rate of LOA between the study group and the control group were statistically significant. The spinal cord atrophy, observed on the sagittal midline plane of C5 and C6 of neutral position MRI, also had high value for the diagnosis of Hirayama disease. Conclusion The loss of attachment and spinal cord atrophy on sagittal midline plane of C5 and C6 may assist in the diagnosis of Hirayama disease.

关 键 词：平山病 中立位 磁共振成像 诊断 

分 类 号：R746.4[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]