平山病的临床特征及颈椎MRI影像特点  

Clinical features and cervical spine MRI findings of Hirayama disease

作　　者：母华国[1] 桑玲[1] 陈海波[1] 陈平友[1] 刘超[1] 陈学强[1] 

机构地区：[1]湖北医药学院附属太和医院放射影像中心,湖北十堰442000

出　　处：《海南医学》2015年第1期49-52,共4页Hainan Medical Journal

摘　　要：目的探讨平山病的临床特征及颈椎自然体位、屈曲体位平扫及增强扫描在平山病中的诊断价值。方法回顾性分析临床确诊的15例平山病患者的临床资料及MRI影像表现,15例均行MRI自然体位、屈曲体位平扫及增强扫描。结果 15例均符合临床诊断标准,全部为男性,平均年龄19.8岁。自然体位颈椎MRI表现为生理曲度伸直或反弓,椎间盘退变,下颈椎脊髓信号异常,椎弓根水平横断面下颈椎硬膜囊与椎板分离;屈曲体位颈椎MRI平扫表现为下颈椎颈髓萎缩、变扁,后方硬膜囊向前移位,局部颈髓受压、变细,背侧硬膜外间隙增宽,内见新月状长T1、长T2异常信号影,增强后呈明显条状强化,增宽的硬膜外间隙内可有异常血管流空信号。结论平山病好发于青春期男性,具有特殊的临床特征,屈曲体位颈椎MRI虽具有特征性影像表现,对平山病的诊断具有高度的准确性,但是自然体位颈椎MRI影像表现不可忽视,两者在平山病的诊断中均具有重要价值。Objective To investigate the clinical characteristics of Hirayama disease and the diagnostic value of plain scan in the neck neutral and flexion position and enhanced scanning in Hirayama disease. Methods Clinical data and MRI findings of 15 Hirayama disease cases were retrospectively analyzed. All 15 cases received plain scan in the neck neutral and flexion position and enhanced scanning. Results 15 cases were consistent with the clinical diagnostic criteria, and all of them were male with an average age of 19.8 years old. Their MRI of cervical spine in the neutral position all showed straight or reverse physiological curvature, degeneration of the intervertebral disc, cervical spinal cord signal abnormalities, separation of cervical vertebral dural sac and plate under the transverse section of vertebral pedicle; while in the neck flexion position, their MRI scans showed lower cervical spine and spinal cord atrophy and flattened, forward displacement of the dural sac, local cervical spinal compressed and thinned, dorsal epidural gap widened, crescent long T1 WI, long T2 WI abnormal signal, clearer strip after enhancement, abnormal vascular flow void signal within the widened epidural space. Conclusion Hirayama disease occurs mainly in adolescent males and has special clinical features. Although the cervical MRI in neck flexion position has characteristic imaging findings and, was accurate in the diagnosis of Hirayama disease, the cervical MRI in neck neutral position can not be ignored in the diagnosis of Hirayama disease. Therefore both of them are significantly valuable in the diagnosis of Hirayama disease.

关 键 词：平山病 颈椎 临床特征 磁共振成像 

分 类 号：R685[医药卫生—骨科学]