脊髓型颈椎病MRI-T_2WI高信号形成影像学表现相关性研究  

THE RELATIONSHIP RESEARCH ON IMAGING MANIFESTATIONS OF MRI-T_2WI INCREASED SIGNAL INTENSITY IN PATIENTS WITH CERVICAL SPONDYLOTIC MYELOPATHY

作　　者：魏鹤新 丁文元[2] 曹来震[1] 

机构地区：[1]河北省廊坊市第四人民医院骨一科,065700 [2]河北医科大学第三医院

出　　处：《中国煤炭工业医学杂志》2015年第4期609-612,共4页Chinese Journal of Coal Industry Medicine

基　　金：廊坊市科技局项目(编号:2013013100)

摘　　要：目的探讨颈椎不稳、颈椎管狭窄、颈髓受压程度、颈髓受压节段与MRI-T2WI脊髓高信号的相关性。方法回顾性分析2006年11月—2009年11月,在河北医科大学第三医院就诊的286例脊髓型颈椎病患者的颈椎正侧位、颈椎过伸过屈位X线片、颈椎MRI。结果脊髓高信号组颈椎不稳的发生率为36.2%,颈椎管狭窄的发生率为35.6%;无高信号组颈椎不稳的发生率为21.4%,颈椎管狭窄的发生率为26.8%,经过χ2检验二组间颈椎不稳和颈椎管狭窄的差异有统计学意义(P<0.05),脊髓内高信号组共174例,其中单节段受压24例,双节段受压72例,三个或者以上节段受压78例;无脊髓高信号组共112例,其中单节段受压42例,双节段受压57例,三个或者以上节段受压13例;脊髓高信号组脊髓压迫程度平均为44.7%。无脊髓高信号组脊髓压迫程度平均为38.7%;经非参数比较的秩和检验二组间的颈髓受压程度、颈髓受压节段差异有统计学意义(P<0.05),Logistic回归模型分析结果显示颈椎不稳、颈椎管狭窄、颈髓受压程度重、颈髓多节段受压是影响脊髓高信号形成的重要因素。结论颈椎不稳、颈椎管狭窄、颈髓受压程度重、颈髓多节段受压是脊髓高信号的形成的重要因素,观察患者的这些指标有助于预测脊髓高信号形成,进而提高脊髓型颈椎病的术后满意率。Objective To investigate the correlation among cervical instability,cervical stenosis,the degree of spinal cord compression,compressed levels of spinal cord and MRI - T2 WI increased signal intensity （ISI）in the spinal cord.Methods From Nov.2006 to Nov.2009,the data of 286 cases of cervical spondy-lotic myelopathy with plain radiograph and C-spine lordotic kyphotic position was analyzed retrospective-ly.Results The rate of cervical instability was 36.2% in ISI group,21.4% in without ISI group.The rate of cervical stenosis was 35.6% in ISI group,26.8% in without ISI group.There were significant differ-ence in cervical instability and cervical stenosis between two groups throughχ2 test（P 〈0.05）.The degree of spinal cord compression was 44.7% in ISI group,38.7% in without ISI group.There were 174 patients in ISI group,including 24 cases in signal compression level,72 cases in double-compression level,78 pa-tients in three or more compression levels.There were significant between two groups in the degree of spi-nal cord compression and compressed levels of spinal cord through nonparametric tests （P 〈0.05）.Logistic regression analysis showed that there were the predominant correlative factors affecting the formation of ISI.Conclusion Cervical instability,cervical stenosis,the degree of spinal cord compression ,compressed levels of spinal cord are the predominant factors affecting the formation of ISI in spinal cord,which can be used to forecast the formation of ISI in spinal cord,and can increase the satisfactory rate of the surgery on cervical spondylotic myelopathy.

关 键 词：颈椎 椎管狭窄 颈椎不稳 磁共振 高信号 

分 类 号：R445.2[医药卫生—影像医学与核医学]