无骨折脱位型颈脊髓损伤患者颈髓的弥散张量成像  

Diffusion Tensor Imaging Study on Cervical Spinal Cord Injury without Radiographic Abnormality

作　　者：赵鹏[1] 陈学明[1] 刘亚东[1] 彭如臣[2] 张殿平[2] 

机构地区：[1]首都医科大学附属北京潞河医院脊柱外科,北京市101149 [2]首都医科大学附属北京潞河医院放射科,北京市101149

出　　处：《中国康复理论与实践》2015年第7期838-840,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨应用磁共振弥散张量成像(DTI)定量分析无骨折脱位型颈脊髓损伤患者的可行性。方法对15例无骨折脱位型颈脊髓损伤患者(患者组)和20例健康志愿者(对照组)行常规MRI和DTI扫描,分别测量各向异性分数(FA)和表观弥散系数(ADC)。结果患者组FA为(0.475±0.109),ADC为(1.438±0.252)×10-3mm2/s。对照组FA为(0.604±0.096),ADC值为(1.371±0.280)×10-3mm2/s。与对照组相比,患者组FA降低(P<0.05),ADC无显著性差异(P=0.267)。纤维束示踪成像(FT)显示,患者组颈髓白质纤维束不同程度受压凹陷、扭曲、减少、稀疏甚至断裂。结论 DTI能够敏感地发现无骨折脱位型颈脊髓损伤,FT能直观显示颈髓白质纤维束的细微损伤,为颈髓损伤程度的临床评估提供客观依据。Objective To apply MR diffusion tensor imaging （DTI） to quantitatively analyze cervical spinal cord injury without radio-graphic abnormality （CSCIWORA）. Methods 15 patients with CSCIWORA and 20 healthy controls were scanned with MRI of convention-al scans and DTI. The fractional anisotropy （FA） and apparent diffusion coefficient （ADC） were measured. Results FA and ADC of the pa-tients were （0.475±0.109） and （1.438±0.252）×10^-3 mm^2/s, respectively. Whereas, they were （0.604±0.096） and （1.371±0.280）×10^-3 mm^2/s in the controls. Compared with the controls, the FA was less （P〈0.05） in the patients, but the ADC was not significantly different （P=0.267）. The fiber tracking （FT） showed the abnormality of white matter fiber tracts of cervical spinal cord in the patients. Conclusion DTI can de-tect the CSCIWORA, and FT can directly display the injuries of white matter fiber tracts of cervical spinal cord, which provide more infor-mation to evaluate the clinical severity of CSCIWORA.

关 键 词：无骨折脱位型颈脊髓损伤 弥散张量成像 各向异性分数 表观弥散系数 纤维束示踪成像 

分 类 号：R651.2[医药卫生—外科学]