平山病的磁共振成像诊断研究  

Study on the application of MRI in the diagnosis of hirayama disease

作　　者：利玉林 汪兵[1] 冯飞[1] 成官迅[1] 向子云[2] LI Yulin;WANG Bing;FENG Fei;CHENG Guanxun;XIANG Ziyun(Department of Radiology,Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院医学影像科,深圳518036 [2]深圳市龙岗区人民医院放射科

出　　处：《功能与分子医学影像学（电子版）》2018年第1期1375-1380,共6页Functional and Molecular Medical Imaging(Electronic Edition)

摘　　要：目的探讨平山病(HD)的磁共振影像表现,以加深对该病的认识和提高对该病的诊断水平。方法回顾性分析16例临床已确诊的HD临床及磁共振资料,结合相关文献,总结HD的影像学特点。结果本组16例均行屈颈位MRI平扫,其中3例行屈颈位增强扫描,9例行颈椎自然体位平扫。屈颈位MRI平扫:16例(100﹪)均出现下段颈髓局部萎缩,4例(25﹪)出现颈髓内异常信号影,14例(87.5﹪)出现后硬脊膜前移,12例(75﹪)出现脊髓局部非对称性变扁,4例(25﹪)出现脊髓对称性变扁,11例(68.7﹪)出现后硬脊膜外腔异常信号,10例(62﹪)出现后硬脊膜外腔血管留空信号。屈颈位增强扫描:3例(100﹪)均出现后硬脊膜外腔异常强化影。颈椎自然体位平扫:9例(100﹪)均出现生理曲度异常。结论 HD的磁共振表现具有一定的特征性,尤其是屈颈位磁共振增强扫描对该病的诊断具有重要的价值。Objective To explore the MRI findings of Hirayama disease and to improve the understanding and the diagnosis accuracy of this disease. Methods MRI and clinical data of 16 cases of Hirayama disease were analyzed retrospectively. Combined with relevant literatures, the imaging characteristics of Hirayama disease were summarized. Results All of 16 cases in our group underwent flexion MRI of the cervical spine, 3 with enhanced scan and 9 with neutral position MRI. On non-enhanced flexion MRI, local atrophy in the lower cervical spinal cord were found in 16 cases（100 %, abnormal signal in the cervical spinal cord were found in 4 cases（25 %, and anterior shifting of the posterior wall of the cervical dura was found in 14 cases（87.5 %. Lower cervical cord flattening was noted in 16 cases（100 %which was symmetric in 4 cases（25 %and asymmetric in 12 cases（75 %. Abnormal signal in the cervical epidural space was noted in 11 cases（68.7 %, and epidural flow void was noted in 10 cases（62 %. On enhanced flexion MRI, abnormal enhancement in the epidural space were found in all 3 cases（100 %. On non-enhanced neutral position MRI, abnormal cervical curvature was noted in all 9 cases（100 %. Conclusions MRI findings of Hirayama disease has certain characteristics, and enhanced flexion MRI of the cervical spine plays an important role in diagnosis of Hirayama disease.

关 键 词：平山病 磁共振成像 影像特征 

分 类 号：A681.5[哲学宗教—马克思主义哲学] R445.2[医药卫生—影像医学与核医学]