MRI脊髓/硬膜囊面积比值测量对脊髓型颈椎病严重程度的评估价值  

The significance of measuring the ratio of spinal cord to dural sac area in evaluating the severity of cervical spondylotic myelopathy by magnetic resonance imaging

作　　者：魏巍 裴仁明 王英 朱芸[3] 孙喆 WEI Wei;PEI Renming;WANG Ying(Department of CT/MRI,Anhui Second People’s Hospital,Anhui,Hefei 230041,China)

机构地区：[1]安徽省第二人民医院CT/MRI科,合肥市230041 [2]安徽医科大学第四附属医院放射科 [3]蚌埠医学院第一附属医院放射科

出　　处：《河北医药》2019年第16期2448-2451,共4页Hebei Medical Journal

摘　　要：目的通过MRI测量脊髓与硬膜囊面积比值,探讨该比值对脊髓型颈椎病的严重程度的评估价值。方法收集不同脊髓受压程度的脊髓型颈椎病患者340例及92例健康志愿者,在3.0TMR轴位T2WI图像上分别测量对照组(A组)C3/4~C6/7椎间盘节段及患者组(B^D组)受压最严重节段脊髓/硬膜囊面积比值,分析其组间差异。在每次扫描的之前,使用日本骨科协会(JOA)量表测量神经损害的程度,分析脊髓/硬膜囊面积比值与JOA评分之间相关性。结果对照组不同节段及同一节段不同年龄、性别C3/4、C4/5、C5/6、C6/7节段脊髓/硬膜囊面积比值差异无统计学意义(P>0.05),B、C、D组脊髓/硬膜囊面积比值明显高于对照组(P<0.05),且随着脊髓受压严重/硬膜囊面积逐渐升高,而JOA评分逐渐降低,差异均有统计学意义(P<0.05)。脊髓/硬膜囊面积比值与JOA评分呈负相关(r=-0.859,P=0.000)。对照组与B组获得最佳检验效能的脊髓/硬膜囊面积比值为0.392,对应的诊断敏感度、特异度、曲线下面积为72.6%、88.6%、0.833。C、D组最佳检验效能临界值为0.580,对应的诊断敏感度、特异度、曲线下面积分别为:75.7%、51.7%、0.664。结论MRI脊髓/硬膜囊面积比值可作为脊髓型颈椎病患者脊髓损伤程度的可靠定量指标。Objective To investigate the significance of measuring the ratio of spinal cord to dural sac area by magnetic resonance imaging(MRI)in evaluating the severity of cervical spondylotic myelopathy by magnetic resonance imaging.Methods A total of 340 patients with cervical spondylotic myelopathy at different degrees of spinal cord compression were enrollled as group B,group C and group D(C3/4~C6/7),and 92 healthy volunteers were enrolled as group A(control group).The area ratios of the C3/4~C6/7 intervertebral disc segments in group A and the most severely compressed segments in group group B,C,D were measured on 3.0T MR axial T2WI images,and the differences among the groups were analyzed.Before each scanning,the Japanese Orthopedics department Association(JOA)scale was used to measure the degree of nerve damage and to analyze the correlation between the ratio of spinal cord/dural sac area and JOA scores.Results There was no significant difference in the area ratio of spinal cord to dural sac at C3/4,C4/5,C5/6,C6/7 segments in different segments,and in the same segment,in different age and gender in group A(P>0.05).However the area ratio of spinal cord to dural sac in group B,C,D was significantly higher than that in group A(P<0.05),which was gradually increased with the severity of the spinal compression,however,the JOA scores were gradually decreased,and the differences were statistically significant(P<0.05).The ratio of medulla spinalis/dural sac area was negatively correlated with JOA score(r=-0.859,P<0.01).The ratio of medulla spinalis/dural sac area to get the best power of test was 0.392,and the corresponding diagnosis sensitiveness,specificity and the area under the curve(AUC)were 72.6%,88.6%,0.833,respectively.However the critical value for the best power of test was 0.580 in group C and group D,the corresponding diagnosis sensitiveness,specificity and the AUC were 75.7%,51.7%,0.664,respectively.Conclusion The ratio of spinal cord to dural sac area measured by MRI can be regarded as a reliable quantitative i

关 键 词：脊髓型颈椎病 脊髓 硬膜囊 测量 临界值 磁共振成像 

分 类 号：R681.531.1[医药卫生—骨科学]