MRI在揭示平山病发病机制中的价值  

Value of MRI in revealing pathogenesis of Hirayama disease

作　　者：郑兴友[1] 廖伟华[1] 周高峰[1] 贾高志[1] 

机构地区：[1]中南大学湘雅医院放射科,湖南长沙410008

出　　处：《中国现代医学杂志》2015年第10期66-69,共4页China Journal of Modern Medicine

摘　　要：目的 分析平山病的MRI表现,探讨MRI诊断平山病及揭示其发病机制的价值。方法 分析28例平山病患者的MRI表现,并与10例健康志愿者对照,总结平山病的MRI表现,并试图探讨发病机制。结果下颈段脊髓萎缩18例,脊髓变扁平7例。病例组可疑病变段脊髓前后径为（5.0±0.4）mm,对照组C5-C7段脊髓前后径为（7.3±0.5）mm,两组间差异有统计学意义（P〈0.01）。28例患者屈颈位均出现C4-7椎体平面硬脊膜后壁前移,硬脊膜外后间隙增宽,病例组病变段后硬脊膜外间隙为（6.3±0.5）mm,对照组为（4.0±0.4）mm,两者的差异存在统计学意义（P〈0.01）。屈颈位增强增宽的硬膜外间隙内可见异常增粗并明显强化的静脉丛,自然位显示静脉丛基本消失;对照组屈颈位颈段后硬膜外间隙未见增粗强化的静脉丛。结论 平山病的MRI表现具有一定的特征性,自然位和屈颈位的颈椎平扫增强MRI可作为平山病的诊断及发病机制探讨的常规手段。[ Objective ] To analyze the MRI features of Hirayama disease, and explore the value of MRI in diag- nosis of Hirayama disease and revealing its pathogenesis. [Methods ] MRI images of 28 cases of Hirayama disease and 10 healthy volunteers were analyzed, and the pathogenesis was explored. [Results] Cervical spinal cord Atrophy was found in 18 cases, and flattening was found in 7 cases. Anteroposterior diameter of suspicious spinal cord in Hirayama disease was （5.0 ± 0.4） mm, Anteroposterior diameter of C5-C7 vertebral bodies in the centrols was （7.3 ± 0.5） mm, and the difference between the two groups was statistically significant （P 〈 0.01）. The posterior wall of dural sac of C4-7 vertebral bodies was forward on neck flexion position MRI in 28 patients, and the epidural space was widened, which was （6.3 ± 0.5） mm, while that of the control group was （4.0 ± 0.4） mm, and statistically significant difference was found between the two groups （P 〈 0.01）. Abnormally thickened and enhanced venous plexus within the epidural space were observed in neck flexion position MRI, while disappeared on natural position MRI. There was no thickened and enhanced venous plexus within the epidural space in the control group on neck flexion position MRI. [ Conclusions ] MRI findings of Hirayama disease has some characteristic features, and the neutral and flexion cervi- cal position MRI can be used as a conventional means for diagnosing Hirayama disease and exploring its mechanisms.

关 键 词：平山病 磁共振成像 

分 类 号：R746.4[医药卫生—神经病学与精神病学]