脊髓损伤扩散峰度成像参数与脊髓型颈椎病患者神经功能评分的相关性研究  

Correlation of Diffusion Kurtosis Imaging in the Cervical Spinal Cord with the Clinical Scores of Patients

作　　者：龙猛[1] 刘娜[1] 梁园梓 冯文杰 李道伟[1] LONG Meng;LIU Na;LIANG Yuan-zi;FENG Wen-jie;LI Dao-wei(Department of Radiology,The People's Hospital of China Medical University&The People's Hospital of Liaoning Province,Shenyang,Liaoning,110016,China)

机构地区：[1]辽宁省人民医院&中国医科大学人民医院,辽宁沈阳110016

出　　处：《现代生物医学进展》2020年第2期290-294,共5页Progress in Modern Biomedicine

基　　金：辽宁省自然科学基金项目(20170540529;20180550254;2019-BS-140)。

摘　　要：目的:研究扩散峰度成像(DKI)参数与脊髓型颈椎病(CSM)患者神经功能评分的相关性及临床意义。方法:选取2018年12月至2019年6月本院收治的CSM患者37例作为研究组及健康志愿者的30例作为对照组,采用GE3.0磁共振机分别对两组人员行磁共振成像(MRI)及DKI扫描,观察其影像学特征及DKI参数的变化情况,并分析DKI参数值与临床行为评分的相关性。结果:所有研究对象的MRI图像均符合诊断要求。志愿者颈髓形态完整、信号均匀;不同年龄组颈髓平均弥散各向异性分数(FA)值、平均弥散峰度(MK)值比较差异无统计学意义(P>0.05)。根据MRI的T2加权图像上椎管受压程度及脊髓信号改变,将实验组分为A、B、C组,对照组与各实验组的MK值、FA值比较差异有统计学意义(P<0.05)。实验组FA值与mJOA评分呈显著正相关(r=0.34),与NDI评分呈负相关(r=-0.38);MK值与mJOA评分呈正相关(r=0.67),与NDI评分呈负相关(r=-0.46)。结论:DKI序列对CSM诊断具有参考较高价值,其参数与临床行为评分关系密切,能够评估早期CSM患者的脊髓损伤情况,并为诊断和治疗提供参考。Objective:To study the correlation between diffusion kurtosis imaging(DKI)parameters and neurological function scores in patients with cervical spinal cord(CSM).Method(s):Total 37 cases of patients diagnosed with CSM of our hospital from December 2017 to June 2018 were enrolled as the study group.There were 30 cases of healthy people were randomly selected as the control group.Use GE 3.0 MRI scanning equipment,the two groups underwent conventional magnetic resonance imaging(MRI)and DKI scan.The imaging features and DKI parameters were observed,and the relationship between fractional anisotropy(FA),mean kurtosis(MK)and clinical scores was analyzed.Result(s):MRI images of all subjects met the requirements of diagnosis and measurement.The cervical spinal of healthy people were smooth,uniform,and complete structure.There was no significant difference in the mean diffusion anisotropy(FA)and mean diffusion kurtosis(MK)between different age groups(P>0.05).According to the degree of spinal canal compression and the changes of spinal cord signal in MRI T2 weighted image,the study group was divided into group A,B and C.There were statistically significant differences between the MK values of the control group and the study groups(F=61.34,P<0.05).There were statistically significant differences in the average FA value between the control and the study groups(F=26.48,P=<0.05).FA value of the study group was positively correlated with mJOA score(r=0.34),negatively correlated with NDI score(r=-0.38),and MK was positively correlated with mJOA score(r=0.67)and negatively correlated with NDI score(r=-0.46).Conclusion(s):The DKI sequence has a high reference value for CSM diagnosis.Its parameters are closely related to the neurological function scores.It can evaluate the spinal cord injury in early CSM patients and provide reference for diagnosis and judging prognosis.

关 键 词：磁共振扩散峰度成像 脊髓损伤 脊髓型颈椎病 平均弥散峰度 

分 类 号：R651.2[医药卫生—外科学] R681.55[医药卫生—临床医学]