磁共振弥散张量成像、mJOA评分对多节段脊髓型颈椎病临床评估及其与血清免疫球蛋白含量相关性研究  

Study on diffusion tensor imaging and mJOA score in clinical evaluation of multilevel cervical spondylotic myelopathy and their correlation with serum immunoglobuin content

作　　者：于学涛[1] 热迪娜·亚生[1] 谢荣[1] YU Xuetao;YASHENG Redina;XIE Rong(Department of Rehabilitation,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang Uygur Autonomous Region 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院康复科,新疆维吾尔自治区乌鲁木齐830001

出　　处：《安徽医药》2022年第1期40-44,共5页Anhui Medical and Pharmaceutical Journal

基　　金：新疆维吾尔自治区人民医院科技引进创新项目(20180318)。

摘　　要：目的探讨磁共振弥散张量成像与血清学免疫血检查在常规磁共振未检出异常信号前预测MCSM病情中的价值。方法选择2019年1—12月期间入住新疆维吾尔自治区人民医院保守治疗/手术治疗的50例MCSM病人作为病例组;纳入同期在医院磁共振室接受颈椎常规核磁共振检查的健康体检者50例作为对照组。全部纳入者均接受磁共振弥散张量成像与mJOA评分评级与血清免疫球蛋白(Ig)含量检测;首先比较对照组不同节段影像学主要参数[向异性(FA)、弥散系数(ADC)、最大脊髓压迫(MSCC)],观察病例组T2信号异常检出情况,比较各组各影像学参数值与mJOA评分;检验FA值、ADC值、mJOA评分与MSCC值的相关性。结果对照组各节段FA、ADC值比较,均差异无统计学意义(P>0.05);对照组、T2信号正常组、T2信号异常组FA值分别为(0.61±0.05)、(0.48±0.04)、(0.40±0.06),其中对照组FA值最高;对照组、T2信号正常组、T2信号异常组ADC值分别为(1.13±0.13)、(1.37±0.12)、(1.46±0.15),其中对照组ADC值最低;对照组、T2信号正常组、T2信号异常组mJOA评分分别为(15.02±1.17)分、(13.11±1.45)分、(10.14±2.51)分,其中对照组mJOA评分最高,差异有统计学意义(P<0.05);较对照组,病例组整体免疫球蛋白G(IgG)含量升高(P<0.05),且T2信号异常组明显高于信号正常组(P<0.05);三组免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、C3含量比较,差异无统计学意义(P>0.05);中重度组T2信号正常组、异常组病人IgG含量高于轻度组(P<0.05),组间IgA、IgM、C3含量比较,差异无统计学意义(P>0.05)。结论经磁共振弥散张量成像与血清IgG检查,有助于在常规磁共振无法检出异常信号时,帮助临床更早地了解病人脊髓早期微小病变,对指导临床制定治疗方案提供了影像学与免疫学定量依据。Objective To compare the serum immunoglobulin content of patients with different functional grades,and to investigate the value of diffusion tensor imaging and immunological examination in predicting the conditions of MCSM before abnormal signals are detected by conventional magnetic resonance imaging.Methods Fifty MCSM patients with conservative treatment or surgical treatment in the People's Hospital of Xinjiang Uygur Autonomous Region from January to December 2019 were selected as the case group,while 50 healthy volunteers who underwent routine cervical magnetic resonance imaging in the magnetic resonance room of the People's Hospital of the Autonomous Region during the same period were included in the control group.All enrolled patients received diffusion tensor imaging,mJOA score classification,and serum immunoglobulin(Ig)content detection.The main imaging parameters[fractional anisotropy(FA),apparent diffusion coefficient(ADC),maximum spinal cord compression(MSCC)]of different segments in the control group were compared,the abnormal detection of T2 signal in the case group was observed,and the value of each imaging parameter and mJOA score in each group were compared.The correlation between FA value,ADC value,mJOA score and MSCC value was detected.The serum Ig content in normal group,abnormal T2 signal group and normal signal group was compared.Results There was no statistical significant difference in the FA and ADC values of different segments in the control groups(P>0.05).The FA values of control group,normal T2 signal group and abnormal T2 signal group were(0.61±0.05),(0.48±0.04)and(0.40±0.06),respectively,of which the FA value of control group was the highest.The ADC values of control group,normal T2 signal group and abnormal T2 signal group were(1.13±0.13),(1.37±0.12)and(1.46±0.15),respectively,of which the ADC value of control group was the lowest.The mJOA scores of control group,normal T2 signal group and abnormal T2 signal group were(15.02±1.17),(13.11±1.45)and(10.14±2.51),respectively,of

关 键 词：椎间盘退行性变 颈椎 脊髓损伤 多节段型脊髓型颈椎病 磁共振弥散张量成像 mJOA评分 血清免疫球蛋白 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.55[医药卫生—诊断学]